How to Use Janus Kinase Inhibitors in the Treatment of Rheumatoid Arthritis? A Clinical Assessment of Risks and Benefits.
Fatima K AlduraibiJasvinder A SinghPublished in: Current rheumatology reports (2023)
Shared decision-making is needed in choosing between JAKi and bDMARDs. Cardiovascular disease, malignancy, and thromboembolic events guide this choice. In patients with active RA despite methotrexate use, tumor necrosis factor inhibitor is conditionally favored over JAKi for low-cardiovascular-risk patients and strongly favored in those with pre-existing cardiovascular disease or multiple cardiovascular risk factors. Suboptimal treatment of treatment-refractory RA patients may pose a greater absolute cardiovascular risk than with JAKi use. Use of aspirin and statin may be considered to reduce cardiovascular risk. New safety data on JAKi has redefined the treatment approach in RA. JAKi remains an important oral medication option in active RA despite treatment with bDMARDs, especially in those with low cardiovascular risk.
Keyphrases
- rheumatoid arthritis
- cardiovascular disease
- cardiovascular risk factors
- end stage renal disease
- type diabetes
- disease activity
- newly diagnosed
- healthcare
- ejection fraction
- chronic kidney disease
- high dose
- ankylosing spondylitis
- metabolic syndrome
- systemic lupus erythematosus
- machine learning
- coronary artery disease
- prognostic factors
- interstitial lung disease
- cardiovascular events
- deep learning
- idiopathic pulmonary fibrosis
- antiplatelet therapy