Keywords
Janus Kinase Inhibitors
DMARDs
Efficacy
Safety
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Abstract
Objective: To compare the efficacy and safety of Janus Kinase inhibitors (JAKi) with traditional DMARDs in the treatment of moderate to severe rheumatoid arthritis (RA). Methods: A search was conducted in electronic databases to select studies published between 2020 and 2025. Fifteen articles were included that addressed outcomes related to disease activity, structural progression, treatment adherence, and adverse events, all critically and systematically analyzed. Results: JAK inhibitors demonstrated comparable or superior efficacy to traditional DMARDs in reducing inflammatory activity and improving patient-reported outcomes such as pain and fatigue. Evidence also indicated benefits in preventing structural progression and better treatment persistence. However, a higher incidence of opportunistic infections, especially herpes zoster, and a possible increase in cardiovascular risk in subgroups of patients with pre-existing risk factors were observed. Conclusion: JAK inhibitors represent an effective and relevant alternative for the treatment of moderate to severe RA, provided their use is based on individualized assessment and strict safety monitoring.
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