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

Abstract

ObjectivesJanus 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.MethodsExisting 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.ResultsThe 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.ConclusionThe consensus provides an assessment of evidence for efficacy and safety of an important therapeutic class with guidance on issues of practical management.

Points to consider for the treatment of immune-mediated inflammatory diseases with Janus kinase inhibitors: a systematic literature research

“…This SLR formed the basis for the formulation of the points to consider for the treatment of IMIDs with JAKi and for the definition of the levels of evidence and strengths of recommendations of each item. 103 …”

Use of Janus kinase inhibitors in the treatment of immunoinflammatory rheumatic diseases: safety issues

“…В ноябре 2020 г. на сайте журнала «Annals of Rheumatic Diseases» был опубликован консенсус экспертов Европейской антиревматической лиги (EULAR), целью которого явилось обобщение опыта применения и-JAK на современном этапе [1]. Авторами указанного консенсуса были разработаны 4 общих принципа и 6 отдельных положений, представленных в табл.…”

“…Авторами указанного консенсуса были разработаны 4 общих принципа и 6 отдельных положений, представленных в табл. 1.…”

Greetings from the editor 2021

“…30 It is always enlightening to see the ambition and determination that govern these initiatives which provide important information based on evidence and expert opinion. In addition, points-toconsider when using Janus kinase inhibitor therapy are published 31 ; of note, this paper was developed by an international task force formed across several specialties and addresses inflammatory diseases beyond the rheumatological ones.…”