https://en.wikipedia.org/wiki/Upadacitinib https://www.rinvoq.com/ Janus kinase inhibitor that is selective for the JAK1 subtype of this enzyme--for the treatment of RA @Jonathan Edwards Any chance that this might also work for ME/CFS? I ask because I am bombarded with TV commercials for Rinvoq where they say that it can significantly reduce the fatigue found in RA. I think you said elsewhere that RA fatigue might be physiologically different from MECFS fatigue? Thanks.
Lots of different treatments that reduce cytokine-driven inflammation in RA reduce fatigue. A Janus kinase inhibitor would work through that route so would be expected to reduce fatigue. But that means we only expect it to reduce fatigue in conditions with cytokine-driven inflammation. Cytokine-driven inflammation is reasonably well indicated by CRP levels - which are normal in ME. So there does not appear to be any cytokine-driven inflammation in ME and we would not expect a Janus kinase inhibitor to help. There are possible exceptions to this argument but at present I don't think we have much to suggest they apply.
https://www.medpagetoday.com/rheumatology/arthritis/89124 Upadacitinib, Abatacept Go Head to Head in RA
Do JAK inhibitors have the potential to work better compared to steroids (methylprednisolone, prednisone, deflazacort etc) when it comes to fatigue associated with cytokine inflammation, or is the main benefit the lack of side effects compared to steroids? In other words, what I suppose I'm asking is: are there cases of cytokine inflammation fatigue that doesn't respond to steroids but responds to Jak inhibitors?
Not that I know of. High dose steroids block inflammation very broadly. The advantage would be selectivity.
Filgotinib was mentioned by Robert Phair among others as being a possible treatment option. There's a trial ongoing, funded by SolveME. Lombardi is the PI: https://solvecfs.org/research-and-r...grants/meet-the-researchers/vincent-lombardi/
