New therapeutic options for the treatment of ankylosing spondylitis.

The pathogenesis of spondyloarthritis (SpA) is multifactorial and involves multiple immune cells and cytokines that are signaled by Janus kinase (JAK). Inhibition of JAK signaling pathways has emerged as a new therapeutic option for patients with inflammatory joint diseases. Despite the proven effect of treatment with anti-IL-17, as well as TNFα inhibitors, some patients with ankylosing spondylitis cannot reach minimal disease activity or remission. This necessitated the development of a new class of molecules, and in recent years more and more clinical studies have proven their role in the treatment of both rheumatoid arthritis and ankylosing spondylitis. JAK inhibition is a promising therapeutic strategy for the treatment of SpA and its application has potential in patients with axial, polyarticular, or extraarticular manifestations of the disease in psoriatic arthritis and ankylosing spondylitis. The present literature review aims to highlight the new therapeutic options offered by this class of target synthetic disease-modifying antirheumatic drugs and to summarize the clinical trial data for tofacitinib, upadacitinib and filgotinib reported to date.