Janus kinase inhibitors for the treatment of Juvenile Idiopathic Arthritis

Juvenile Idiopathic Arthritis (JIA) is a heterogeneous group of inflammatory arthritides encompassing at least six different categories, each with distinct clinical and biological characteristics. Despite significant advancements in the treatment of JIA, many cases of arthritis and/ or associated comorbidities such as chronic uveitis and interstitial lung disease (ILD) are refractory to current therapies. Janus kinase (JAK) inhibitors (JAKi) are small molecules or target–specific Disease Modifying Anti Rheumatic Drugs (tsDMARDs) that selectively inhibit janus kinases (JAKs) and block the JAK – Signal Transducers and Activators (STAT) pathway and the down steam proinflammatory effects associated with its activation. Herein, we review JAKi approved for the treatment of JIA and comment on JAKi currently with off- label use, with special considerations for their use in JIA-associated extraarticular manifestations and complications.