JAK inhibitor

Janus kinase inhibitor

From Wikipedia, the free encyclopedia

Jump to: navigation, search

Janus kinase inhibitors, also known as JAK inhibitors or jakinibs,^[1] are a type of medication that functions by inhibiting the activity of one or more of the Janus kinase family of enzymes (JAK1, JAK2, JAK3, TYK2), thereby interfering with the JAK-STAT signaling pathway. These inhibitors have therapeutic application in the treatment of cancer and inflammatory diseases^[1][2] such as rheumatoid arthritis.^[3]

Contents

 [hide] 

• 1 Mechanism of action
• 2 Molecule design
• 3 Examples
  • 3.1 Approved compounds
  • 3.2 In clinical trials
  • 3.3 Experimental drugs
  • 3.4 Failed agents
• 4 References

Mechanism of action[edit]

Cytokines play key roles in controlling cell growth and the immune response. Many cytokines function by binding to and activating type I and type II cytokine receptors. These receptors in turn rely on the Janus kinase (JAK) family of enzymes for signal transduction. Hence drugs that inhibit the activity of these Janus kinases block cytokine signalling.^[1]
More specifically, Janus kinases phosphorylate activated cytokine receptors. These phosphorylated receptors in turn recruit STAT transcription factors which modulate gene transcription.
The first JAK inhibitor to reach clinical trials was tofacitinib. Tofacitinib is a specific inhibitor of JAK3 (IC₅₀ = 2 nM) thereby blocking the activity of IL-2, IL-4, IL-15 and IL-21. Hence T_h2 cell differentiation is blocked and therefore tofacitinib is effective in treating allergic diseases. Tofacitinib to a lesser extent also inhibits JAK1 (IC₅₀ = 100 nM) and JAK2 (IC₅₀ = 20 nM) which in turn blocks IFN-γ and IL-6 signalling and consequently T_h1 cell differentiation.^[1]

Molecule design[edit]

Some JAK1 inhibitors are based on a benzimidazole core.^[4]

This section needs expansion. You can help by adding to it. (April 2016)

Examples[edit]

Approved compounds[edit]

• Ruxolitinib (trade names Jakafi/Jakavi) against JAK1/JAK2 for psoriasis, myelofibrosis,^[5][6][7] and rheumatoid arthritis.^[8] Approved by the U.S. Food and Drug Administration (FDA) in November 2011 for myelofibrosis (intermediate- or high-risk) and polycythemia vera, in patients with an inadequate response or intolerance to hydroxyurea.^[9]
• Tofacitinib (trade names Xeljanz/Jakvinus, formerly known as tasocitinib and CP-690550) against JAK3 for psoriasis and rheumatoid arthritis.^[10] U.S. FDA approved it in November 2012 for rheumatoid arthritis (moderately-to-severely active) in patients who had an inadequate response or intolerance to methotrexate.^[11]

In clinical trials[edit]

• Baricitinib (LY-3009104, previously INCB-28050) against JAK1/JAK2 starting phase IIb for rheumatoid arthritis.^[12]
• Filgotinib (G-146034, GLPG-0634) against JAK1 for rheumatoid arthritis and Crohn's disease.^[13]
• Gandotinib (LY-2784544) against JAK2 for myeloproliferative neoplasms.^[14]
• Lestaurtinib (CEP-701) against JAK2 for acute myeloid leukemia (AML).^[15]
• Momelotinib (GS-0387, CYT-387) against JAK1 and JAK2 for myeloproliferative disorders^[16] and relapsed/refractory metastatic pancreatic cancer.^[17]
• Pacritinib (SB1518) against JAK2 for relapsed lymphoma and advanced myeloid malignancies,^[18] also myelofibrosis,^[19] myeloproliferative neoplasms and myelodysplastic syndrome.^[20]
• Upadacitinib (ABT-494) against JAK1 starting phase III for rheumatoid arthritis.^[21]

Experimental drugs[edit]

• Cucurbitacin I (JSI-124).^[22]
• CHZ868 — a type II JAK2 inhibitor for use in myeloproliferative disorders and chronic myelomonocytic leukemia (CMML).^[23][24]
• Tofacitinib for alopecia universalis.^[25]
• Topical tofacitinib and ruxolitinib for alopecia.^[26]

Failed agents[edit]

• Fedratinib (SAR302503). Fedratinib was a JAK2 inhibitor for the treatment of primary myelofibrosis (including in patients those previously treated with ruxolitinib), polycythemia vera and essential thrombocythemia.^[27]

References[edit]

1. ^ Jump up to: ^{a b c d} Kontzias A, Kotlyar A, Laurence A, Changelian P, O'Shea JJ (Aug 2012). "Jakinibs: a new class of kinase inhibitors in cancer and autoimmune disease". Current Opinion in Pharmacology. 12 (4): 464–70. doi:10.1016/j.coph.2012.06.008. PMC 3419278. PMID 22819198. 
2. Jump up ^ Pesu M, Laurence A, Kishore N, Zwillich SH, Chan G, O'Shea JJ (Jun 2008). "Therapeutic targeting of Janus kinases". Immunological Reviews. 223: 132–42. doi:10.1111/j.1600-065X.2008.00644.x. PMC 2634846. PMID 18613833. 
3. Jump up ^ Selective JAK inhibitors in development for rheumatoid arthritis. Norman 2014
4. Jump up ^ Benzimidazole Derivatives as Potent JAK1-Selective Inhibitors. Kim et al. 2015
5. Jump up ^ Vaddi, K; Sarlis, NJ; Gupta, V (10 October 2012). "Ruxolitinib, an Oral JAK1 and JAK2 Inhibitor, in Myelofibrosis". Expert Opinion on Pharmacotherapy. 13 (16): 2397–407. doi:10.1517/14656566.2012.732998. PMID 23051187.  |access-date= requires |url= (help)
6. Jump up ^ "Ruxolitinib (Jakafi) for Myelofibrosis". The Medical Letter on Drugs and Therapeutics. 54 (1387): 27–8. 2 April 2012. PMID 22469651. 
7. Jump up ^ Ostojic, A; Vrhovac, R; Verstovsek, S (November 2011). "Ruxolitinib for the Treatment of Myelofibrosis". Drugs of Today. 47 (11): 817–27. doi:10.1358/dot.2011.47.11.1708829. PMID 22146225.  |access-date= requires |url= (help)
8. Jump up ^ Mesa, RA; Yasothan, U; Kirkpatrick, P (1 February 2012). "Ruxolitinib". Nature Reviews. Drug Discovery. 11 (2): 103–4. doi:10.1038/nrd3652. PMID 22293561.  |access-date= requires |url= (help)
9. Jump up ^ "Jakafi (ruxolitinib) Tablets, for Oral Use. Full Prescribing Information" (PDF). Incyte Corporation. Wilmington, DE 19803. Retrieved 16 July 2016. 
10. Jump up ^ Zerbini, CA; Lomonte, AB (May 2012). "Tofacitinib for the Treatment of Rheumatoid Arthritis". Expert Review of Clinical Immunology. 8 (4): 319–31. doi:10.1586/eci.12.19. PMID 22607178.  |access-date= requires |url= (help)
11. Jump up ^ "Xeljanz (tofacitinib) Tablets, for Oral Use and Xeljanz XR (tofacitinib) Extended Release Tablets, for Oral Use. Full Prescribing Information". Pfizer Labs. Division of Pfizer, Inc. NY, NY 10017. Retrieved 16 July 2016. 
12. Jump up ^ "Incyte Earns $19M Milestone from Lilly on Start of Phase IIb Trial with RA Candidate". GEN. Genetic Engineering & Biotechnology News. 20 October 2010. Retrieved 16 July 2016. 
13. Jump up ^ "Clinical Trials with GLPG0634". ClinicalTrials.gov. Retrieved 16 July 2016. 
14. Jump up ^ "Clinical trials with LY2784544 (Gandotinib)". ClinicalTrials.gov. Retrieved 16 July 2016. 
15. Jump up ^ Shabbir, M; Stuart, R (March 2010). "Lestaurtinib, a Multitargeted Tyrosine Kinase Inhibitor: from Bench to Bedside". Expert Opinion on Investigational Drugs. 19 (3): 427–36. doi:10.1517/13543781003598862. PMID 20141349.  |access-date= requires |url= (help)
16. Jump up ^ "Momelotinib in Transfusion-Dependent Adults with Primary Myelofibrosis (PMF) or Post-polycythemia Vera or Post-essential Thrombocythemia Myelofibrosis (Post-PV/ET MF)". ClinicalTrials.gov. Retrieved 16 July 2016. 
17. Jump up ^ "Momelotinib Combined with Capecitabine and Oxaliplatin in Adults with Relapsed/Refractory Metastatic Pancreatic Ductal Adenocarcinoma". ClinicalTrials.gov. Retrieved 16 July 2016. 
18. Jump up ^ Hart, S; Goh, KC; Novotny-Diermayr, V; Hu, CY; Hentze, H; Tan, YC; Madan, B; Amalini, C; Loh, YK; Ong, LC; William, AD; Lee, A; Poulsen, A; Jayaraman, R; Ong, KH; Ethirajulu, K; Dymock, BW; Wood, JW (November 2011). "SB1518, a Novel Macrocyclic Pyrimidine-based JAK2 Inhibitor for the Treatment of Myeloid and Lymphoid Malignancies" (PDF). Leukemia. 25 (11): 1751–9. doi:10.1038/leu.2011.148. PMID 21691275. Retrieved 16 July 2016. 
19. Jump up ^ "Oral Pacritinib Versus Best Available Therapy to Treat Myelofibrosis with Thrombocytopenia". ClinicalTrials.gov. Retrieved 16 July 2016. 
20. Jump up ^ "Pacritinib in Combination with Low Dose Decitabine in Intermediate-High Risk Myelofibrosis or Myeloproliferative Neoplasm (MPN)/Myelodysplastic Syndrome (MDS)". ClinicalTrials.gov. Retrieved 16 July 2016. 
21. Jump up ^ Henriques, C (29 January 2016). "AbbVie Launches Phase 3 Trial for Rheumatoid Arthritis". Rheumatoid Arthritis News. BioNews Services, LLC. Retrieved 16 July 2016. 
22. Jump up ^ Blaskovich, MA; Sun, J; Cantor, A; Turkson, J; Jove, R; Sebti, SM (15 March 2003). "Discovery of JSI-124 (Cucurbitacin I), a Selective Janus Kinase/Signal Transducer and Activator of Transcription 3 Signaling Pathway Inhibitor with Potent Antitumor Activity against Human and Murine Cancer Cells in Mice". Cancer Research. 63 (6): 1270–9. PMID 12649187. Retrieved 16 July 2016. 
23. Jump up ^ Meyer, SC; Keller, MD; Chiu, S; Koppikar, P; Guryanova, OA; Rapaport, F; Xu, K; Manova, K; Pankov, D; O'Reilly, RJ; Kleppe, M; McKenney, AS; Shih, AH; Shank, K; Ahn, J; Papalexi, E; Spitzer, B; Socci, N; Viale, A; Mandon, E; Ebel, N; Andraos, R; Rubert, J; Dammassa, E; Romanet, V; Dölemeyer, A; Zender, M; Heinlein, M; Rampal, R; Weinberg, RS; Hoffman, R; Sellers, WR; Hofmann, F; Murakami, M; Baffert, F; Gaul, C; Radimerski, T; Levine, RL (13 July 2015). "CHZ868, a Type II JAK2 Inhibitor, Reverses Type I JAK Inhibitor Persistence and Demonstrates Efficacy in Myeloproliferative Neoplasms". Cancer Cell. 28 (1): 15–28. doi:10.1016/j.ccell.2015.06.006. PMC 4503933. PMID 26175413.  |access-date= requires |url= (help)
24. Jump up ^ Stallard, J (23 July 2015). "Discovery Could Boost New Therapies for Myeloproliferative Neoplasms". Memorial Sloan Kettering Cancer Center. Retrieved 16 July 2016. 
25. Jump up ^ Gershon, E (19 June 2014). "In Hairless Man, Arthritis Drug Spurs Hair Growth — Lots of It". Yale News. Retrieved 16 July 2016. 
26. Jump up ^ Harel, S; Higgins, CA; Cerise, JE; Dai, Z; Chen, JC; Clynes, R; Christiano, AM (23 October 2015). "Pharmacologic Inhibition of JAK-STAT Signaling Promotes Hair Growth". Science Advances. 1 (9): e1500973. doi:10.1126/sciadv.1500973. PMC 4646834.  |access-date= requires |url= (help)
27. Jump up ^ "Sanofi Discontinues Clinical Development of Investigational JAK2 Agent Fedratinib (SAR302503)" (PDF). Sanofi Oncology. Retrieved 16 July 2016. 

[show] v t e Pharmacology: enzyme i