Janus Kinase Inhibitors: Hope for Biotherapy in Sub-Saharan Africa?

Introduction: Tofacitinib is an oral Janus Kinase (JAK) inhibitor used in the treatment of rheumatoid arthritis (RA) and in many other conditions [1-3]. After promising results in clinical and preclinical trials, Tofacitinib was extensively evaluated in pivotal trials in 2012 and its efficacy on demonstrated structural damage [4]. Thus, Tofacitinib has been approved for the treatment of patients with RA who have an inadequate response to methotrexate [5]. Biologics are used routinely in many countries but remain difficult to access in sub-Saharan Africa [6]. The cost of biotherapies, their side effects, in particular infectious ones, and their presentation in injectable form constitute a brake on the use of these new treatments. The advent of a new therapy administered by bone would represent an excellent alternative for Africa. We thus report the case of a patient who failed conventional treatments and who has benefited from Tofacitinib (Xeljanz 5mg®).