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Title: JAK inhibitors and black box warnings: what is the future for JAK inhibitors?
Austin Authors: Tokareva, Kate;Reid, Pankti;Yang, Victor;Liew, David F L ;Peterson, Alexander C;Baraff, Aaron;Giles, Jon;Singh, Namrata
Affiliation: Medical Student, University of Washington, Seattle, WA, USA.
Division of Rheumatology and Committee on Clinical Pharmacology and Pharmacogenomics, Department of Medicine, University of Chicago Biological Sciences Division, Chicago, IL, USA.
Clinical Pharmacology and Therapeutics
VA Puget Sound Healthcare System, Seattle, WA, USA.
Columbia University, New York, NY, USA.
Division of Rheumatology, Department of Medicine, University of Washington, Seattle, WA, USA.
Issue Date: 18-Aug-2023
Date: 2023
Publication information: Expert Review of Clinical Immunology 2023-08-18, 19(11)
Abstract: Janus kinase inhibitors (JAKi) have dramatically improved the treatment of various autoimmune, and myeloproliferative disorders. Recently concern has arisen regarding their safety in patients with rheumatoid arthritis. Here we provide a comprehensive summary of the major current and emerging JAKi and their indications, address recent studies on comparative safety, and provide insight into their future and use. We emphasize that the application of the research findings on a case-by-case basis should consider a patient's age, comorbidities, disease for which JAKi is being considered, disease activity, the JAKi target(s), alternate treatment options available for the patient, and the planned duration of JAKi. Rheumatologists are used to prescribing therapies in which a risk to benefit assessment is required as well as with screening and monitoring for safety of medications. Thus, rheumatologists are already practiced in applying specific criteria to effectively screen and monitor patients who are candidates for JAKi therapy. Ongoing research will help to clarify any mechanisms underlying differential safety signals between JAK and other therapies, what the balance between risk and efficacy is, who the susceptible subpopulations are, and whether safety signals are shared between different JAKis and across indications.
DOI: 10.1080/1744666X.2023.2249237
ORCID: 0000-0002-7645-0919
Journal: Expert Review of Clinical Immunology
PubMed URL: 37596779
ISSN: 1744-8409
Type: Journal Article
Journal Article
Subjects: Cancer
JAK inhibitors
comparative safety
rheumatoid arthritis
shared decision making
Appears in Collections:Journal articles

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