JAK inhibitors are known to increase the risk of herpes zoster infections between between 3-5 fold.  Two recent reports suggest variable efficacy when JAK inhibitor (JAKi) treated patients are vaccinated with the recombinant herpes zoster subunit vaccine (RZV). 

Safety risks found in a postmarketing trial with the Janus-associated kinase (JAK) inhibitor tofacitinib (Xeljanz) appear to have influenced prescribing patterns across the class for rheumatoid arthritis (RA) patients in the Veterans Affairs (VA) health system, researchers found.

A JAMA systematic review and meta-analysis has showed the use of JAK inhibitors (JAKi) in immune-mediated inflammatory skin diseases was not associated with increased risk of all-cause mortality, major adverse cardiovascular events (MACE), or venous thromboembolism (VTE) (compared to the placebo or active comparator cohorts).

Even though polymyalgia rheumatica is not perceived by many physicians as a severe diagnosis, its diagnosis and management actually propose significant challenges. I'd like to talk about those challenges, and what directions our path forward can include to advance our understanding and improve the treatment of patients who have PMR.

Despite the official recognition of PMR as a distinct disease more than 60 years ago, patients with PMR are still largely treated with steroids (glucocorticoids, mostly prednisone). The persistent broad use of glucocorticoids in PMR is related to their quick initial efficacy in the majority of patients with PMR, their low price and the lack of alternative treatments and paucity of glucocorticoid-sparing treatments.

In my earlier blog, PMR: glad or bad tidings? I mentioned our PMR Voices 2021 public engagement project. This project brought home to me as a physician that although our expertise is essential, one unfortunate side-effect is that our very expertise can give us “blinkers”. One result of our “blinkers” is that we may fail to see the extent of the information gap between us and our patients with newly-diagnosed PMR. 

Another infliximab biosimilar has been FDA approved, but this new version of Inflectra can be given subcutaneously for patients with inflammatory bowel disease.

Dr. Jack Cush reviews RheumNow's top entries the PMR Campaign, news, journal reports and regulatory actions. #PMR Polymyalgia rheumatica is very common, yet there is little research on the Dx & Management of PMR by #PCPs! Mayo study prevalence 701 per 100,000 (women=870 and men =508 per 100,000 population). https://t.co/7JZFeRPRnn

JAK inhibitors obviously have dominated a lot of the discussion in our therapeutic landscape over the last couple of years. What about their use in polymyalgia rheumatica? Let's consider.