JAK inhibitors in the management of extra-intestinal manifestations in inflammatory bowel disease

Extra-intestinal manifestations (EIMs) commonly occur in patients with inflammatory bowel diseases (IBD) and contribute significantly to morbidity and reduced quality of life. Their management remains challenging. Recently, the development of Janus Kinase (JAK) inhibitors has expanded the therapeutic options of luminal IBD, and three JAK inhibitors, tofacitinib, upadacitinib, and filgotinib, have been approved for IBD treatment, while a growing body of evidence suggests that JAK inhibitors may be a promising therapeutic option for the management of EIMs, particularly those affecting the joints and skin. In this comprehensive review, we aim to provide the available evidence concerning the impact of JAK inhibitors on EIMs treatment and analyze their underlying mechanisms of action.