Points to consider for the treatment of immune-mediated inflammatory diseases with Janus kinase inhibitors: A consensus statement

Peter Nash, Andreas Kerschbaumer, Thomas Dörner, Maxime Dougados, Roy M. Fleischmann, Klaus Geissler, Iain McInnes, Janet E. Pope, Désirée Van Der Heijde, Michaela Stoffer-Marx, Tsutomu Takeuchi, Michael Trauner, Kevin L. Winthrop, Maarten De Wit, Daniel Aletaha, Xenofon Baraliakos, Wolf Henning Boehncke, Paul Emery, John D. Isaacs, Joel KremerEun Bong Lee, Walter P. Maksymowych, Marieke Voshaar, Lai Shan Tam, Yoshiya Tanaka, Filip Van Den Bosch, René Westhovens, Ricardo Xavier, Josef S. Smolen

Research output: Contribution to journalReview articlepeer-review

6 Scopus citations

Abstract

Objectives Janus kinase inhibitors (JAKi) have been approved for use in various immune-mediated inflammatory diseases. With five agents licensed, it was timely to summarise the current understanding of JAKi use based on a systematic literature review (SLR) on efficacy and safety. Methods Existing data were evaluated by a steering committee and subsequently reviewed by a 29 person expert committee leading to the formulation of a consensus statement that may assist the clinicians, patients and other stakeholders once the decision is made to commence a JAKi. The committee included patients, rheumatologists, a gastroenterologist, a haematologist, a dermatologist, an infectious disease specialist and a health professional. The SLR informed the Task Force on controlled and open clinical trials, registry data, phase 4 trials and meta-Analyses. In addition, approval of new compounds by, and warnings from regulators that were issued after the end of the SLR search date were taken into consideration. Results The Task Force agreed on and developed four general principles and a total of 26 points for consideration which were grouped into six areas addressing indications, treatment dose and comedication, contraindications, pretreatment screening and risks, laboratory and clinical follow-up examinations, and adverse events. Levels of evidence and strengths of recommendations were determined based on the SLR and levels of agreement were voted on for every point, reaching a range between 8.8 and 9.9 on a 10-point scale. Conclusion The consensus provides an assessment of evidence for efficacy and safety of an important therapeutic class with guidance on issues of practical management.

Original languageEnglish (US)
Pages (from-to)71-87
Number of pages17
JournalAnnals of the rheumatic diseases
Volume80
Issue number1
DOIs
StatePublished - Jan 1 2021

Keywords

  • Autoimmune Diseases
  • Inflammation
  • Therapeutics

ASJC Scopus subject areas

  • Immunology and Allergy
  • Rheumatology
  • Immunology
  • Biochemistry, Genetics and Molecular Biology(all)

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