JAK Inhibitors vs TNF Inhibitors: Effects on Administration, Efficacy, and Safety

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Tumor necrosis factor inhibitors (TNFis) and Janus kinase inhibitors (JAKis) present with differing characteristics and mechanisms of action (MOA), both between the 2 classes and within each class.

• Multiple characteristics distinguish JAKis from TNFis. For example, JAKis are stable small molecule proteins with a short half-life whereas TNFis are heat-sensitive monoclonal antibodies with a long half-life. How do their differences affect administration, efficacy, and safety outcomes?
• The MOA within the TNFi class also varies. Etanercept binds both TNF-a and TNF-b with high affinity whereas infliximab, adalimumab, golimumab, and certolizumab-pegol bind to TNF-a with high affinity but not TNF-b. What implications are associated with these different binding activities