Safety and efficacy in the nursing care of people with rheumatic diseases on janus kinase inhibitor therapy

Rheumatol Int. 2022 Dec;42(12):2125-2133. doi: 10.1007/s00296-022-05185-2. Epub 2022 Aug 18.

Abstract

Nurses's support of patients needs an evidence base as much as that of specialists management. However, some more practical aspects need specific questions that are not addressed in medical societies' recommendations. Our objective was to investigate the effect of Janus kinase inhibitors (jakinibs) on efficacy, safety, infections, cardiovascular risk, vaccination, pregnancy and lactation, interactions, surgery, and switch in adult patients with rheumatic diseases. We used the methodology for rapid reviews. Medline was searched for systematic reviews of randomised clinical trials and longitudinal observational studies reporting on the target aspects, without limits, yielding 540 titles, of which 70 articles were selected for detailed reading after the screening of title and abstract. In the case of no systematic review being published on a specific question, we resorted to the information provided by primary studies. The efficacy and safety profiles are similar to that of TNF-inhibitors to which they are compared in most studies; however, there is an increased risk of herpes zoster infections with jakinibs. The evidence on pregnancy, surgery and switches between jakinibs is very limited, although, so far, there are no major issues to inform patients about or to implement specific measures. In general, evidence to support nursing management in patients being treated with jakinibs is of moderate quality and scarce, ought to the recent incursion of jakinibs as a treatment.

Keywords: Baricitinib; Drug interactions and drug substitution; Efficacy; General surgery; JAK inhibitors; Janus kinases/antagonists and inhibitors; Safety pregnancy; Tofacitinib; Tyrosine kinase inhibitors; Vaccination.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Female
  • Humans
  • Janus Kinase Inhibitors* / adverse effects
  • Rheumatic Diseases* / drug therapy
  • Systematic Reviews as Topic

Substances

  • Janus Kinase Inhibitors