RA Pain and Fatigue Improved After 12 Months on JAK Inhibitors

Written by Ted Samson

Posted on November 3, 2026

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An observational study in Italy followed 440 adults with rheumatoid arthritis (RA). Participants took medications called Janus kinase (JAK) inhibitors. After 12 months, they reported significant improvements in pain, fatigue, and other symptoms.

The improvements were also seen among adults 65 and older and those with type 2 diabetes or multiple heart and metabolic health conditions.

What Are JAK Inhibitors?

Janus kinase (JAK) inhibitors are a newer class of disease-modifying antirheumatic drugs (DMARDs) used to treat inflammatory diseases like RA. They work by blocking JAK enzymes, which are proteins inside cells. These proteins help send signals that trigger inflammation. Blocking these signals helps reduce inflammation and may slow joint damage.

🗳️ Have you tried a JAK inhibitor for rheumatoid arthritis?

Yes, and it helped

Yes, but it didn’t help

No, but I’m interested

No, and I’m not interested

In the United States, the Food and Drug Administration (FDA) has approved certain JAK inhibitors to treat RA. These medications are generally used in adults with moderately to severely active disease. These adults must have tried at least one tumor necrosis factor (TNF) inhibitor that didn’t work well or caused side effects they couldn’t tolerate.

TNF inhibitors are medications that block a protein involved in inflammation. JAK inhibitors may be used alone or with certain other DMARDs, such as methotrexate.

Pain and Fatigue Improved Over 12 Months

For the study, researchers reviewed medical records from nine rheumatology centers in Italy. Participants were taking one of four JAK inhibitors: tofacitinib, baricitinib, upadacitinib, or filgotinib. Filgotinib is used for RA in Europe and some other countries, but it’s not FDA-approved in the United States.

Researchers tracked symptoms and disease activity at the start of treatment and after three, six, and 12 months. Improvements were seen as early as three months and were maintained through the 12-month follow-up.

Pain and fatigue were measured on a scale from 0 to 10, with higher scores reflecting worse symptoms.

After 12 months of treatment, the average pain and fatigue scores and number of tender joints decreased:

Pain — From 6.1 to 3.07
Fatigue — From 6.2 to 3.6
Tender joints — From 8 to 3

In an exploratory analysis, researchers also found similar improvements in disease activity among certain groups. These included adults 65 and older, those with type 2 diabetes, and those with at least two conditions such as high blood pressure, type 2 diabetes, or unhealthy cholesterol levels.

Important Considerations

As with any treatment, JAK inhibitors may cause side effects. These treatments carry FDA warnings about serious risks, including major heart-related events, cancer, blood clots, serious infections, and death. Some risks may be greater for older adults and people with heart-related risk factors.

In this study from Clinical Rheumatology, about 19 percent of participants experienced adverse events, or unwanted effects. Most were mild and reversible. About 8 percent of participants stopped taking a JAK inhibitor because of an adverse event. However, the study was too small and too short to reliably assess the risk of rare but serious side effects.

The study was also observational and didn’t include a comparison group. This means researchers found a connection between JAK inhibitor treatment and improved symptoms, but they couldn’t determine whether the medications caused those improvements.

When starting a new treatment, it’s important to discuss potential side effects with your doctor.

What Do the Findings Mean?

This study adds to evidence that JAK inhibitors may help reduce pain, fatigue, and disease activity in people with RA. The findings may also be encouraging for older adults and those living with RA and diabetes or other heart and metabolic health conditions, although more research is needed to confirm these results.

JAK inhibitors may not work the same way for everyone. Treatment decisions depend on factors such as your symptoms, medical history, other medications, and individual health risks.

If you’re living with RA and your current treatment isn’t working as well as you’d hoped, talk with your rheumatologist about other options. Together, you can weigh the potential benefits and risks of different treatment options based on your needs and goals.

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