VIDEO: Cardiovascular concerns tied to JAK inhibitor impacts patients, providers

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So, I think it has a huge impact. It has been the topic of a lot of discussions, not only just the ACR, but several other rheumatology meetings, and you know, I'm sure linked as well with dermatology meetings where there are other indications for the JAK inhibitors.

I think the biggest impact is in the sense that of course, there are patients who were on these drugs that they're coming back and like they're asking us, is it safe for me to continue this drug or do I need to switch to a different mechanism of action or M O A drug? And of course, as providers ourselves, we are thinking to ourselves maybe do I start this new patient on this new diagnosed R A on a JAK inhibitor versus considered another drug?

So I think we are thinking a lot, we are thinking hard in terms of risk stratifying the patients while making these decisions in the clinic in terms of, you know, what was the patient population that the oral surveillance trial target? Or what was the data based on? So, you know, 50 and older patient who had one or more cardiovascular risk factors. So we know it was a population at risk for cardiovascular events down the lane. So for sure, you know, keeping that information in mind for example, I will decide that, okay, if I'm talking to a 65 year old patient who's, you know, not getting under remission with a conventional synthetic edema maybe I would not be picking a JAK inhibitor for that person who might also have two year prior history of a melanoma or lung cancer, right? Versus a person who's like newly diagnosed RA at 35 years of age. And technically the oral surveillance trial data doesn't apply to them. Tune out for a JAK inhibitor in that patient with a little more peace of mind.

And at the end of the day it's all a shared decision making you present the data to the patient and, you know, make a make an informed decision. Involve the patient, patient's caregiver if they are involved. And, then ultimately, I think it's at the end of the day, a shared decision. Of course, you know, when we are starting a new drug or talking to a patient who hasn't seen anything that's a different person versus a person's already failed multiple other drugs and JAK inhibitor was the only drug that helped control their disease they are thinking very hard that even in spite of what you presented to me, the data, I just don't want the quality of life to suffer again.

You know, so again, it all ends up being a quality of life versus a quantity of life or you know the burden that we place on their life. I'd rather be able to do things today than worry about my tomorrow. So, you know, it's, at the end of the day patients and their goals are different per each person. So I think a lot goes into each patient's decision making and is a bit more involved than we can, you know just make a blanket statement.