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©The Author(s) 2026. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Pharmacol Ther. Mar 5, 2026; 17(1): 112788
Published online Mar 5, 2026. doi: 10.4292/wjgpt.v17.i1.112788
Updated review of Janus kinase inhibitors for the management of inflammatory bowel disease
Sayan Malakar, Suprabhat Giri, Anuraag Jena, Preetam Nath
Sayan Malakar, Department of Gastroenterology, King George Medical University, Lucknow 226003, Uttar Pradesh, India
Suprabhat Giri, Preetam Nath, Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Bhubaneswar 751024, Odisha, India
Anuraag Jena, Department of Gastroenterology, IMS and SUM Hospital, Bhubaneshwar 751029, Odisha, India
Author contributions: Giri S and Jena A contributed to the conception and design of the manuscript; Malakar S, Giri S, Jena A, and Nath P contributed to the literature review, analysis, data collection, interpretation, and the critical revision of the initial manuscript; Malakar S and Giri S drafted the initial manuscript; All the authors approved the final version of the manuscript.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to disclose.
Corresponding author: Suprabhat Giri, Associate Professor, Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences, Kushabhadra Campus, 5, KIIT Road, Patia, Bhubaneswar 751024, Odisha, India. supg19167@gmail.com
Received: August 7, 2025
Revised: September 1, 2025
Accepted: November 24, 2025
Published online: March 5, 2026
Processing time: 189 Days and 1.4 Hours
Core Tip

Core Tip: Janus kinase inhibitors are reserved for moderate-to-severe inflammatory bowel disease (IBD) after biologic failure or steroid dependence. Carefully selecting patients based on their cardiovascular, thromboembolic, and infection-related risks is of paramount importance. Tofacitinib is an excellent choice for patients with moderate to severe ulcerative colitis (UC) and acute severe UC. Upadacitinib is currently approved for both refractory UC and Crohn’s disease (CD); however, emerging data suggest its beneficial role in acute severe UC. Limited evidence exists for the combination of small molecules and other biologicals in patients with difficult-to-treat IBD and peri-anal CD. Close monitoring of side effects is advocated in such patients. More data is warranted on their role in extraintestinal manifestations, pediatric and pregnant patients with IBD.