Janus kinase inhibitors – a new effective treatment option for refractory isolated non-infectious ocular inflammatory disorders

Vidic Krhlikar, Nina (author), Tomšič, Matija (author), Jaki Mekjavić, Polona (author), Klobučar, Pia (author), Bregar, Janez (author), Šurlan Popović, Katarina (author), Vidović Valentinčič, Nataša (author)

The Janus kinase (JAK) pathway regulates inflammatory responses, with dysregulation implicated in various autoimmune disorders, including non-infectious orbital or ocular inflammation. While corticosteroids are commonly used, their long-term use is limited by side effects. Janus kinase inhibitors (JAK-i) present an emerging therapeutic option. This study systematically reviewed the effectiveness and safety of JAK-i in managing isolated non-infectious ocular inflammation. A comprehensive literature review utilizing MEDLINE/PubMed, Cochrane and Web of Science search identified studies reporting isolated non-infectious ocular inflammation cases treated with JAK-i up to May 2025. Search terms combined JAK-i keywords with ocular inflammation terms. Among 21 isolated non-infectious ocular inflammation cases treated with JAK-i, tofacitinib was predominant. Most patients received JAK-i after disease-modifying antirheumatic drug therapy, with additional corticosteroid usage. Ocular inflammation was successfully controlled in 21 out of 21 patients, with one case of herpetic keratitis necessitating additoinal systemic virostatics. JAK-i show promise as an effective option for refractory isolated non-infectious ocular inflammation. However, further research is warranted with longer follow-up periods. Safety concerns underline the importance of personalized risk-benefit assessments in JAK-i therapy. While limitations exist, this review supports the potential of JAK-i use in managing isolated non-infectious ocular inflammation.

• Language: English
• Keywords: Janus kinase inhibitors, Non-infectious ocular inflammation, Uveitis
• Work type: Article
• Typology: 1.02 - Review Article
• Organization: MF - Faculty of Medicine
• Publication status: Published
• Publication version: Version of Record
• Year: 2026
• Number of pages: Str. 162-171
• Numbering: Vol. 65, no. 1
• PID: 20.500.12556/RUL-182265
• UDC: 617.7
• ISSN on article: 1333-9451
• DOI: 10.20471/acc.2026.65.01.15
• COBISS.SI-ID: 276084995
• Publication date in RUL: 08.05.2026

Record is a part of a journal

• Title: Acta clinica Croatica
• Shortened title: Acta clin. Croat.
• Publisher: Sestre milosrdnice University Hospital, Institute for Clinical Medical Research
• ISSN: 1333-9451
• COBISS.SI-ID: 6272831

Licences

• License: CC BY-NC-ND 4.0, Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
• Link: http://creativecommons.org/licenses/by-nc-nd/4.0/
• Description: The most restrictive Creative Commons license. This only allows people to download and share the work for no commercial gain and for no other purposes.

Secondary language

• Language: Croatian

Abstract

Putanja Janus kinase (JAK) regulira upalne odgovore, uz deregulaciju uključenu u raznim autoimunim poremećajima uključujući nezaraznu upalu orbite ili oka. Iako se kortikosteroidi redovito primjenjuju u takvim slučajevima, njihova dugotrajna uporaba ograničena je nuspojavama, a tu se pojavljuju inhibitori Janus kinaze (JAK-i) kao mogućnost liječenja. U ovom istraživanju sustavno je obrađena učinkovitost i sigurnost JAK-i u liječenju izolirane nezarazne očne upale. U sveobuhvatnom pregledu literature pretragom izvora MEDLINE/PubMed, Cochrane i Web of Science identificirane su studije koje izvještavaju o slučajevima izolirane nezarazne očne upale liječene pomoću JAK-i do svibnja 2025. godine. Pretražni pojmovi kombinirali su ključne riječi JAK-i s terminima očne upale. Taofacitinib je prevladavao među 21 slučajem izolirane nezarazne očne upale. Većina bolesnika primala je JAK-i nakon terapije antireumatskim lijekovima koji mijenjaju tijek bolesti, uz dodatnu primjenu kortikosteroida. Očna upala je uspješno kontrolirana u 21 od 21 bolesnika, pričem je jedan slučaj herpetskog keratitisa zahtijevao dodatne sistemske virostatike. JAK-i obećava kao učinkovita opcija za refraktornu izoliranu nezaraznu upalu oka. Međutim, potrebna su daljnja istraživanja s dužim vremenom praćenja. Pitanja sigurnosti naglašavaju važnost personalizirane procjene rizika i koristi liječenja pomoću JAK-i. Iako postoje ograničenja, ovaj pregled podupire potencijal primjene JAK-i u liječenju izolirane nezarazne očne upale.