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Treatment guide:
JAK inhibitors
for Crohn’s disease
Immune system
Unlike other targeted treatments for moderate to severe Crohn’s disease, JAK inhibitors are
taken orally as pills. Participants in clinical trials
of JAK inhibitors in Crohn’s disease have taken these medications either once or twice a day.
In ulcerative colitis, tofacitinib is twice daily, while upadacitinib is a once-a-day pill. In Crohn’s disease, upadacitinib is once daily.
Oral medication
JAK inhibitors for
Crohn’s disease
Treatment guide:
Heart effects
JAK inhibitors work inside cells to block JAK signaling activity. By disrupting signaling within immune cells, they can help prevent inflammation that causes disease.
Research has found that treatment with upadacitinib reduces inflammatory signaling and inflammation in the intestines of people with active Crohn’s disease.
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However, in rare cases, serious side effects can occur. The Food and Drug Administration (FDA) has added warnings to some JAK inhibitors — including upadacitinib and tofacitinib — that taking these medications for long periods may increase the likelihood of developing severe effects, such as blood clots, heart effects, and some types of cancer.
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Most side effects of JAK inhibitors are mild and either resolve on their own or can be managed with supportive care. The healthcare team may run blood tests, such as cholesterol tests or blood counts, to monitor for potential side effects while using a JAK inhibitor.
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Research has also noted remission of symptoms with tofacitinib.
Results with upadacitinib also suggest that JAK inhibitor treatment can promote mucosal healing in the intestines and may prevent further intestinal damage.
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By helping to control inflammation in the colon, JAK inhibitors can help manage symptoms of Crohn’s disease.
In a 2021 clinical trial, 61% of people who took upadacitinib had a remission of symptoms, which continued for at least 30 months with treatment.
Gastrointestinal symptoms
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Other infections can also occur. In most cases, these are manageable, but some may be severe. Any symptoms of illness, such as fever or cough, should be promptly discussed with a healthcare professional.
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JAK inhibitors work by inhibiting the immune system, which can lead to immune-related side effects.
One possible side effect of JAK inhibitors is
herpes zoster, or shingles. This occurs when the immune system can no longer suppress the shingles-causing virus in nerve cells, allowing it to become activated and cause symptoms.
Immune-related side effects
Immune cell activation in Crohn’s disease occurs when pro-inflammatory molecules known as cytokines bind to receptors on the surface of these cells. When cytokines bind, they trigger JAK proteins attached to the internal portion of the receptors inside the cell. This creates a signaling cascade that “turns on” immune cells and promotes inflammation.
Living with Crohn’s disease can be stressful and may affect a person’s mental health.
In a 2021 study, people with Crohn’s disease who took upadacitnib experienced significant improvements in various mental health and social and emotional well-being measures. These included less anxiety, depression, and discomfort and an improved ability to complete regular activities at work and home.
Mental health
