Points to Consider for the Treatment of Immune-Mediated Inflammatory Diseases With Janus Kinase Inhibitors: A Consensus Statement
Nash P, Kerschbaumer A, Dorner T, Dougados M, Fleischmann RM, Geissler K, McInnes I, Pope JE, van der Heijde D, Stoffer-Marx M, Takeuchi T, Trauner M, Winthrop KL, de Wit M, Aletaha D, Baraliakos X, Boehncke W-H, Emery P, Isaacs JD, Kremer J, Lee EB, et al. - 2021 Jan;80(1):71-87. doi: 10.1136/annrheumdis-2020-218398. Epub 2020 Nov 6.
JAKi are approved in various immune-mediated inflammatory diseases. With five JAKi now licensed, this paper reviews key points to consider in their use to assist clinicians, patients, and other stakeholders once the decision is made to commence JAKi.
The consensus was developed by a Steering Committee and an expanded Task Force using EULAR standard operating procedures. The committee included patients as well as experts in rheumatology, gastroenterology, haematology, dermatology, and infectious disease. The consensus was based on evaluation of a systematic literature review with new approvals and warnings from regulators issued after the end of the literature review search date also considered.
Four general principles and 26 points for consideration were agreed. These are grouped into indications, treatment dose and comedication, contraindications, pre-treatment screening and risks, laboratory and clinical follow-up examinations, and adverse events. The general principles highlight the importance of shared decision making with the patient when initiating JAKi. The points to consider are designed to assist the clinician once the decision to prescribe JAKi has been made.