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Gecacitinib (formerly known as jaktinib or jacksitinib) is an orally bioavailable, small-molecule dual inhibitor of Janus kinases (JAK1, JAK2, JAK3, and TYK2) and activin receptor type-1 (ACVR1), developed by Zelgen. By inhibiting JAK family kinases, gecacitinib blocks the JAK-STAT signaling pathway, thereby suppressing the production of inflammatory cytokines and reducing splenomegaly. Additionally, its inhibition of ACVR1 downregulates hepcidin expression, which improves iron metabolism and ameliorates anemia in patients with myelofibrosis. Gecacitinib is approved in China (under the brand name Zepuping) for the treatment of intermediate- or high-risk myelofibrosis, and is in late-stage clinical development for various autoimmune and inflammatory conditions, including alopecia areata, atopic dermatitis, ankylosing spondylitis, plaque psoriasis, and vitiligo.
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