Article Impact Level: HIGH Data Quality: STRONG Summary of Annals of the Rheumatic Diseases, S0003496725001815. https://doi.org/10.1016/j.ard.2025.01.032 Dr. Peter Nash et al.
Points
- The new recommendations address evolving uses and safety concerns, particularly in rheumatoid arthritis, psoriasis, Crohn’s disease, and ulcerative colitis, amid rising concerns about cardiovascular and cancer risks.
- The guidelines stress individualized patient evaluation before prescribing JAK inhibitors, considering factors like age, organ function, and comorbidities, alongside infection risk management through screening and vaccination.
- A task force of clinicians, patients, and healthcare experts convened to update the 2019 guidelines, integrating the latest research and optimizing dosage, co-medication strategies, and monitoring protocols.
- The guidelines shift toward personalized treatment, balancing safety concerns with therapeutic efficacy while offering detailed strategies for mitigating adverse effects.
- Published in the Annals of the Rheumatic Diseases, the guidelines serve as a key reference for clinicians, promoting shared decision-making and ensuring the safe and effective use of JAK inhibitors in inflammatory disease management.
Summary
The updated guidelines for Janus kinase (JAK) inhibitors aim to address the evolving use and safety concerns of these medications in the treatment of chronic inflammatory diseases. JAK inhibitors, which have been approved for conditions such as rheumatoid arthritis, psoriasis, Crohn’s disease, and ulcerative colitis, have expanded indications over the years. However, recent studies have raised concerns about potential risks, including cardiovascular disease and cancer. A multidisciplinary task force, including clinicians, patients, and healthcare professionals with expertise in JAKi therapy, convened to review the latest scientific findings and update the 2019 guidelines. This update provides comprehensive recommendations on dosage, co-medication strategies, contraindications, monitoring, and adverse effects, addressing the growing complexity of their use.
The task force, guided by the European Alliance of Associations for Rheumatology’s standard operating procedures, underscored the importance of an individualized risk-benefit assessment when prescribing JAK inhibitors. The updated guidelines emphasize considering patient-specific factors such as age, liver and kidney function, and pre-existing comorbidities before initiating JAKi therapy. Additionally, the group highlighted the need for careful screening and vaccination strategies to prevent infections, a key concern with these drugs. The consensus statement reflects a shift toward more personalized treatment plans, incorporating the latest evidence on safety, including the potential risk of cardiovascular complications and cancer, while also providing guidance on optimizing the efficacy of JAK inhibitors.
These guidelines, published in the Annals of the Rheumatic Diseases, provide a much-needed resource for clinicians to safely navigate the expanding role of JAK inhibitors in clinical practice. They not only assist in mitigating risks but also emphasize the importance of shared decision-making between healthcare providers and patients. As JAK inhibitors continue to gain prominence in managing inflammatory diseases, these updated guidelines are crucial for ensuring their optimal and safe use across diverse patient populations.
Link to the article: https://ard.eular.org/article/S0003-4967(25)00181-5/fulltext
References Nash, P., Kerschbaumer, A., Konzett, V., Aletaha, D., Dörner, T., Fleischmann, R., McInnes, I., Primdahl, J., Sattar, N., Tanaka, Y., Trauner, M., Winthrop, K., De Wit, M., Askling, J., Baraliakos, X., Boehncke, W.-H., Emery, P., Gossec, L., Isaacs, J. D., … Smolen, J. S. (2025). Expert consensus statement on the treatment of immune-mediated inflammatory diseases with Janus kinase inhibitors: 2024 update. Annals of the Rheumatic Diseases, S0003496725001815. https://doi.org/10.1016/j.ard.2025.01.032
