Speaker A
Can you imagine a powerful new class of medication that could decrease inflammation, relieve the pain, and improve the function of your joints?
Dr. Diana Girnita explains JAK inhibitors for arthritis, their benefits, risks, and recommended tests before treatment.
Key Takeaways
- JAK inhibitors are effective oral treatments for several autoimmune diseases, improving joint function and reducing inflammation.
- Pre-treatment screening and vaccination are critical to minimize serious infection risks.
- Patients benefit from the convenience of oral dosing compared to injectable biologics.
- Monitoring lipid levels and infection symptoms during treatment is important for safety.
- Consultation with a healthcare provider is essential to weigh benefits and risks before starting JAK inhibitors.
Summary
- JAK inhibitors are a new class of oral medications that reduce inflammation and pain in autoimmune diseases like RA, PsA, AS, and alopecia.
- The first JAK inhibitor was approved by the FDA in 2011 for myelofibrosis, with subsequent approvals for rheumatoid arthritis and other autoimmune conditions.
- Three main JAK inhibitors used in rheumatology are Tofacitinib (Xeljanz), Baricitinib (Olumiant), and Upadacitinib (Rinvoq).
- These drugs offer convenience as they are taken orally, usually once daily, avoiding injections or infusions.
- JAK inhibitors work by blocking Janus kinase enzymes that signal immune cells to produce inflammatory cytokines.
- Recommended pre-treatment tests include CBC, comprehensive metabolic panel, and screening for tuberculosis and hepatitis B/C.
- Common side effects include increased risk of infections such as shingles and tuberculosis; vaccination and testing are advised before therapy.
- JAK inhibitors may cause increased cholesterol levels in 10-20% of patients, which sometimes correlates with reduced inflammation.
- Patients should monitor for infection symptoms like fever, rash, or cough and contact their doctor immediately if these occur.
- The video also references other autoimmune diseases treated with JAK inhibitors and additional resources on alopecia treatment.
Full Transcript — Download SRT & Markdown
Speaker A
If you suffer from RA, PsA, AS, or even alopecia/hair loss, you should watch this video!
Speaker A
Why? Because I will discuss a new class of medications called JAK inhibitors. These are the biologics that come in a form of a pill and not injections or infusions. I will also explain to you the major risks or potential side effects, so stay until
Speaker A
the end to learn everything that you need to know before you discuss it with your doctor.
Speaker A
Intro: Hi, I'm Dr. Diana Girnita, and in this video, I am going to explain to you all you have to know about a relatively new class of medication called JAK inhibitors.
Speaker A
In 2011, the FDA approved the first medication from this class, a drug for a rare form of cancer called myelofibrosis. It took another year, and in 2012, until another
Speaker A
drug called Xeljanz/Tofacitinib was approved for rheumatoid arthritis.
Speaker A
Then in 2018, Olumiant/Baricitinib was approved also for rheumatoid arthritis. And then in 2019, Rinvoq/Upadacitinib was also approved for rheumatoid arthritis.
Speaker A
In a few years and after more research, these drugs were also approved for patients with
Speaker A
psoriatic arthritis, ankylosing spondylitis, ulcerative colitis, Crohn’s disease, atopic dermatitis, and
Speaker A
in 2022, Olumiant/Baricitinib was approved for severe cases
Speaker A
of alopecia areata/hair loss. If you are interested to learn more about how to treat
Speaker A
hair loss if you suffer from an autoimmune disease, watch this video on my channel!
Speaker A
How JAK inhibitors work? JAK inhibitors, or Janus kinase inhibitors, are a type of targeted synthetic drug,
Speaker A
meaning that it is a medication produced in a laboratory that will block a family of
Speaker A
enzymes called JAK. These enzymes are crucial in sending a signal to the nucleus of certain immune
Speaker A
system cells to produce multiple molecules of inflammation, like multiple types of cytokines. By blocking the activity of these enzymes, your immune system cells will stop producing these
Speaker A
cytokines, and that will reduce the inflammation and also the pain, and you will feel better!
Speaker A
What JAK inhibitors we use in rheumatology? There are about 10 JAK inhibitors approved on the market, but we only have 3 that we use
Speaker A
in rheumatology to treat RA, PsA, and AS. They can also be used for other
Speaker A
autoimmune diseases like UC or Crohn's disease and even in atopic dermatitis. These drugs are: Tofacitinib (Xeljanz), Baricitinib (Olumiant), Upadacitinib (Rinvoq). The big advantage of these drugs is that they come in a form of a pill. Many of them being
Speaker A
administered like 1 pill/day. This is very convenient for many of my patients,
Speaker A
as they are happy to get a pill rather than having an injection every week,
Speaker A
or every 2 weeks, or even an infusion. Taking 1 pill/day gives you the freedom
Speaker A
to travel easier and get the medication with you in the bag, not carry any freezer bags or not spending one day or more per month to get to an infusion center.
Speaker A
What are the tests recommended before you start therapy with JAK inhibitors? I always recommend the following tests to my patients: CBC - to check for all the cell counts and make sure patients do not have
Speaker A
low platelets, low WBC, or anemia; comprehensive metabolic panel to
Speaker A
evaluate the kidney and liver function; check for tuberculosis, hepatitis B/C. What are the major side effects?
Speaker A
While JAK inhibitors came with great benefits,
Speaker A
they may also pose some serious side effects. The most common side effects are: increased risk of serious infections, especially herpes zoster infections that can cause shingles.
Speaker A
Shingles is a reactivation of the chickenpox virus when your immune system is too low. That
Speaker A
will cause a rash usually on one side of the body that can be very painful. To avoid that,
Speaker A
I always advise my patients to get vaccinated for shingles before they start therapy with
Speaker A
JAK inhibitors to decrease the chance of getting this infection reactivated. Another possible infection can be tuberculosis, that is why I recommend testing before. There
Speaker A
were also reports of other infections, so if you develop any signs of infection like fever, chills,
Speaker A
night sweats, cough, rashes, or even diarrhea and vomiting, call your doctor immediately. In 10-20% of patients, the therapy with JAK inhibitors
Speaker A
can cause an increase in lipid levels like an increase in cholesterol levels. However, sometimes this increase in cholesterol was also associated with decreased levels of
Speaker A
inflammation. If the increase in cholesterol is noted, talk to your doctor if you need to
Topics:JAK inhibitorsXeljanzRinvoqBaricitinibarthritis treatmentrheumatoid arthritispsoriatic arthritisankylosing spondylitisautoimmune diseaseDr. Diana Girnita
