Points to consider for the treatment of immune-mediated inflammatory diseases with Janus kinase inhibitors: a consensus statement.
Ann Rheum Dis
; 80(1): 71-87, 2021 01.
Article
em En
| MEDLINE
| ID: mdl-33158881
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.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Artrite Reumatoide
/
Espondilite Anquilosante
/
Doenças Inflamatórias Intestinais
/
Artrite Psoriásica
/
Inibidores de Janus Quinases
Tipo de estudo:
Guideline
/
Prognostic_studies
/
Systematic_reviews
Limite:
Humans
País/Região como assunto:
Europa
Idioma:
En
Revista:
Ann Rheum Dis
Ano de publicação:
2021
Tipo de documento:
Article