Date of Award

Spring 5-2025

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Carr, Kristen

Keywords

JAK inhibitors, rheumatoid arthritis, inflammation reduction, inflammation, inflammatory markers, methotrexate, CRP, ESR, symptom reduction

Abstract

Rheumatoid arthritis (RA) is a chronic autoimmune disorder that causes joint inflammation and damage. This paper investigates the comparative efficacy of Janus kinase (JAK) inhibitors versus methotrexate (MTX) in reducing joint inflammation in adult patients with rheumatoid arthritis (RA). The study addresses the critical research question: In adult patients with RA, does treatment with JAK inhibitors or methotrexate demonstrate superior efficacy in reducing joint inflammation? A literature review was conducted analyzing various clinical trials, including phase II and III studies, that evaluated the effectiveness of JAK inhibitors, both as monotherapy and in combination with MTX. The findings indicate that JAK inhibitors, particularly tofacitinib and baricitinib, consistently show superior or equivalent efficacy in achieving American College of Rheumatology (ACR) response rates and low disease activity scores compared to MTX, especially in patients with inadequate responses to traditional therapies. This literature review concludes that JAK inhibitors represent a promising alternative for RA management, particularly for patients intolerant to MTX, and highlights the need for further research to explore their longterm efficacy and safety in diverse patient populations.

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