scholarly journals Selectivity of Janus Kinase Inhibitors in Rheumatoid Arthritis and Other Immune-Mediated Inflammatory Diseases: Is Expectation the Root of All Headache?

Drugs ◽  
2020 ◽  
Vol 80 (12) ◽  
pp. 1183-1201
Author(s):  
Masayoshi Harigai ◽  
Suguru Honda
Keyword(s):  
Rheumatoid Arthritis ◽  
Kinase Inhibitors ◽  
Inflammatory Diseases ◽  
Janus Kinase ◽  
Janus Kinase Inhibitors ◽  
Immune Mediated

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

2020 ◽  
Vol 80 (1) ◽  
pp. 71-87 ◽  
Author(s):  
Peter Nash ◽  
Andreas Kerschbaumer ◽  
Thomas Dörner ◽  
Maxime Dougados ◽  
Roy M Fleischmann ◽  
...  
Keyword(s):  
Kinase Inhibitors ◽  
Consensus Statement ◽  
Task Force ◽  
Inflammatory Diseases ◽  
Steering Committee ◽  
Janus Kinase ◽  
Expert Committee ◽  
Efficacy And Safety ◽  
Janus Kinase Inhibitors ◽  
Immune Mediated

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.

scholarly journals Monitoring the transition of patients on biologics in rheumatoid arthritis: Consensus guidance for pharmacists

2021 ◽  
Vol 19 (3) ◽  
pp. 2377
Author(s):  
Denis Choquette ◽  
Jonathan Chan ◽  
Mohammad Bardi ◽  
Carolyn Whiskin ◽  
Gabriel Torani ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Best Practices ◽  
Kinase Inhibitors ◽  
Unmet Need ◽  
Nominal Group Technique ◽  
Janus Kinase ◽  
Nominal Group ◽  
Nocebo Effect ◽  
Patient Journey ◽  
Janus Kinase Inhibitors

Background: Recent approvals for novel agents such as the small molecule Janus kinase inhibitors (JAKi), combined with the advent of biosimilars has widened the gamut of available therapeutic options in the treatment of rheumatoid arthritis (RA). This combined with the introduction of mandatory non- medical switches to biosimilars in some jurisdictions by both public and private payors has led to a significant increase in the volume of therapeutic changes for patients. Pharmacists are well positioned to ensure effective and safe transitions, however there is a significant unmet need for objective and subjective clinical guidance around therapy as well disease state monitoring in RA that facilitates best practices throughout the patient journey. Objective: In this paper we aim to create a consensus derived monitoring algorithm for pharmacists to facilitate best practices throughout therapeutic transitions from originator biologic to other originator biologics, biosimilars, and Janus kinase inhibitors in RA. Methods: The Nominal Group Technique (NGT) was used to understand if consensus could be found among the participants. Clinically relevant questions were developed to capture solutions to the identified unmet need. The faculty considered the questions as individuals, and privately generated answers/ideas. After discussion and consideration, the participants ranked the ideas and established a consensus. Results: Based on the outcome of the consensus discussions, an algorithm was created to help guide pharmacists through therapeutic transitions in RA. The tool covers important topics such as pre-transition considerations, avoiding the nocebo effect for biosimilars, specific considerations for each drug or class, monitoring efficacy, and when to refer. Conclusions: New classes of anti-rheumatic drugs including JAKi, along with the introduction of biosimilars are presenting more opportunity for therapeutic changes and monitoring in patients with RA. We hope our evidence-based consensus derived guidance tool will assist frontline pharmacists in supporting their patients to a successful therapeutic transition in RA.

PMS1 Variables Associated with Choice of Janus Kinase Inhibitors (JAKs) vs Biologics for Treatment of Rheumatoid Arthritis (RA)

2021 ◽  
Vol 24 ◽  
pp. S138
Author(s):  
J.A. Singh ◽  
J. Radtchenko ◽  
N. Soloman ◽  
K. Huston ◽  
S.M. Helfgott ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Kinase Inhibitors ◽  
Janus Kinase ◽  
Janus Kinase Inhibitors
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