BACKGROUND AND AIMS: A number of Janus kinase (JAK) inhibitors (tofacitinib, 
filgotinib, upadacitinib) have been tested for moderate and severe Crohn's 
disease (CD) in randomized control trials (RCTs). However, data on their 
comparative efficacy and tolerability is lacking. We aimed to study their 
performance comparatively, by means of network meta-analysis (NWM).
METHODS: We searched the Pubmed/Medline, EMBASE, and Cochrane Library databases 
for relevant RCTs through March 2021 and data was extracted. A bayesian NWM was 
performed to investigate the efficacy and tolerability of the above JAK 
inhibitors and to explore their rank order in treating moderate and severe CD 
patients. The cumulative ranking probability for each intervention at the end of 
treatment period, was evaluated by means of surfaces under cumulative ranking 
(SUCRA) values.
RESULTS: Four RCTs were entered into this NWM. They included 811 patients 
totally, randomized to 11 interventions, i.e. placebo, tofacitinib (1mg BID, 5mg 
BID, 10mg BID, 15mg BID), filgotinib 200 OD and upadacitinib (3 mg BID, 6 mg 
BID, 12 mg BID, 24 mg BID and 24mg OD). Two upadacitinib doses (6 mg BID and 24 
mg BID) and filgotinib 200 OD, performed best as judged by the relevant forest 
plots, league matrixes, rankograms, SUCRA values (96.7%, 84,6 %and 78,7%, 
respectively) and the clustered ranking plots for efficacy and tolerability.
CONCLUSIONS: Upadacitinib 6 mg BID, upadacitinib 24 mg BID and filgotinib 200 OD 
performed better as induction therapies in comparison to control therapies. 
Consequently, these regimens may play a therapeutic role in CD and therefore 
they merit further evaluation with well-designed RCTs.