JAK Monotherapy Shows Efficacy in RA Review
A systematic review found Janus kinase inhibitor monotherapy improved outcomes vs methotrexate or placebo, but direct comparisons with combination therapy were limited.
By
Andrea Surnit
May 22, 2026
Objective: To evaluate the efficacy of Janus kinase inhibitors (JAKi) monotherapy in patients with rheumatoid arthritis compared to methotrexate or placebo.
Key Findings: JAKi monotherapy showed improved clinical, functional, and radiographic outcomes compared to methotrexate or placebo. Upadacitinib monotherapy achieved higher ACR 50% response rates at week 12 compared to methotrexate in methotrexate-naive patients. Baricitinib monotherapy demonstrated higher ACR 20% response rates compared to placebo. Filgotinib showed efficacy as both monotherapy and in combination therapy, with favorable outcomes compared to methotrexate alone. Interpretation:
Limitations: Variability in trial design, populations, treatment regimens, follow-up duration, and outcome measures. Most studies did not directly compare JAKi monotherapy with combination therapy. Older patients and those with elevated cardiovascular risk were underrepresented. Most trials were industry-sponsored, potentially introducing reporting bias. Conclusion:
