PT - JOURNAL ARTICLE AU - Peter Nash AU - Andreas Kerschbaumer AU - Thomas Dörner AU - Maxime Dougados AU - Roy M Fleischmann AU - Klaus Geissler AU - Iain McInnes AU - Janet E Pope AU - Désirée van der Heijde AU - Michaela Stoffer-Marx AU - Tsutomu Takeuchi AU - Michael Trauner AU - Kevin L Winthrop AU - Maarten de Wit AU - Daniel Aletaha AU - Xenofon Baraliakos AU - Wolf-Henning Boehncke AU - Paul Emery AU - John D Isaacs AU - Joel Kremer AU - Eun Bong Lee AU - Walter P Maksymowych AU - Marieke Voshaar AU - Lai-Shan Tam AU - Yoshiya Tanaka AU - Filip van den Bosch AU - René Westhovens AU - Ricardo Xavier AU - Josef S Smolen TI - Points to consider for the treatment of immune-mediated inflammatory diseases with Janus kinase inhibitors: a consensus statement AID - 10.1136/annrheumdis-2020-218398 DP - 2021 Jan 01 TA - Annals of the Rheumatic Diseases PG - 71--87 VI - 80 IP - 1 4099 - http://ard.bmj.com/content/80/1/71.short 4100 - http://ard.bmj.com/content/80/1/71.full SO - Ann Rheum Dis2021 Jan 01; 80 AB - 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.