NEW YORK — At the Interdisciplinary Autoimmune Summit, investigators described the latest research on JAK inhibitors, which demonstrated these are effective and appear to be comparable to tumor necrosis factor inhibitors for rheumatoid arthritis.
“Janus kinase [JAK] inhibitors have demonstrated efficacy in rheumatoid arthritis and appear to be comparable in most patients to tumor necrosis factor inhibitors,” Gregg J. Silverman, MD, professor of medicine and pathology and director of the Laboratory of B-cell Immunobiology at the New York University School of Medicine, said in a presentation.
Gregg J. Silverman
In their presentation, Silverman and Maria Greenwald, MD, from Desert Medical Advances in California, discussed the pathophysiology of rheumatoid arthritis (RA), how JAK inhibitors block intracellular signaling in RA, and the efficacy and safety of JAK inhibitors. They described the results of the ORAL-START trial for the currently FDA-approved tofacitinib — how it demonstrated efficacy superior to methotrexate as monotherapy — and the RA-BUILD, RA-BEACON and RA-BEAM studies for baricitinib — which showed efficacy similar to other TNF inhibitors.
In addition, they mentioned relevant safety information, including the increased risk for herpes zoster. Greenwald noted she ensures all her patients are vaccinated in her clinic before prescribing a JAK inhibitor.
“We personally, in our clinic, do not prescribe a JAK inhibitor unless the patient has been fully vaccinated,” Greenwald said. “We have never had anyone say, ‘I do not want a shingles shot.’” – by Will Offit
Greenwald M and Silverman GJ. Changing the treatment paradigm by inhibiting key intracellular pathways: A 3D view of targeted therapy for the patient with rheumatoid arthritis. Presented at: Interdisciplinary Autoimmune Summit; March 24-26, 2017; New York City.
Disclosures: Greenwald reports she is a consultant for Eli Lilly, Pfizer and Merck; has received support from AbbVie, Amgen, Astellas, Bristol-Myers Squibb, Astra Zeneca, Galapagos, Gilead, Eli Lilly, Pfizer, Merck, UCB and the NIH. Silverman reports he is a consultant for Genentech, Eli Lilly, Bristol Myers Squibb and Roche; is on the speakers board for Genentech and Bristol-Myers Squibb; and has received support from the Arthritis Foundation, Lupus Research Institute, Rheumatology Research Foundation and NIH.