Janus Kinase Inhibitors As Emerging Therapy in the Treatment of Psoriatic Arthritis: A Narrative Review of Efficacy, Safety, and Future Perspective.

Psoriatic arthritis (PsA) is a chronic, immune-mediated inflammatory disorder that affects peripheral joints, entheses, and the skin, driven by the dysregulation of key cytokine pathways and often necessitating targeted immunomodulatory therapy for optimal disease control. While biologic therapies targeting tumor necrosis factor (TNF), interleukin-17 (IL-17), and interleukin-23 (IL-23) pathways have transformed PsA management, limitations in efficacy, tolerability, and patient access persist. Janus kinase (JAK) inhibitors represent an emerging class of targeted therapies, offering a distinct mechanism of action by disrupting intracellular signaling pathways involved in inflammation. This narrative review summarizes recent clinical trial data and real-world evidence on the efficacy and safety of JAK inhibitors, with particular attention to their comparative performance against adalimumab and other biologic classes. To facilitate patient selection and monitoring, important safety factors such as cardiovascular risk, cancer, and venous thromboembolism are contextualized within the most recent guidelines. Beyond summarizing outcomes, we critically examine the clinical implications of integrating JAK inhibitors into PsA treatment algorithms. As the therapeutic landscape continues to evolve, further long-term studies are essential to establish the optimal role of JAK inhibitors in clinical practice and clarify their position within the broader treatment framework for PsA. These findings can help guide treatment choices and support decisions made with patients.