Philip Mease, MD, Director of Rheumatology Research at the Swedish Rheumatology Research Group, discusses why he believes some rheumatologists are skeptical of JAK inhibitors and where they fit in current treatment algorithms.
Patient compliance and adherence to medication are essential when for clinicians attempting to manage any chronic condition, which made the onset of JAK inhibitors for rheumatic diseases a monumental development.
With the ability to treat rheumatoid arthritis with an oral therapy, it alleviated much of the treatment burden that is associated with subcutaneous treatments. Yet more than half a decade after the first approval, there still appears to be skepticism among some rheumatologists about the class while clinical trials are ongoing evaluating their efficacy for psoriatic arthritis and other rheumatic conditions.
Few rheumatologists have been involved in as many studies and trials examining the use of JAK inhibitors—and rheumatic treatments as a whole—in recent years as Philip Mease, MD, director of Rheumatology Research at Swedish Rheumatology Research Group and clinical professor at the University of Washington School of Medicine. For his perspective on the evolving role of JAK inhibitors in rheumatic conditions, MD Magazine® sat down with Mease at the 2019 American College of Rheumatology annual meeting in Atlanta, GA.
MD Mag: Where do JAK inhibitors fit into treatment algorithms for patients with psoriatic arthritis?
Mease: Some if you've seen some lack of enthusiasm amongst some rheumatologist, I think it partly has to do with the fact that the JAK inhibitors, although used in rheumatoid arthritis for a number of years, have only recently been approved for psoriatic arthritis, and none are approved for axial spondyloarthritis. We're now seeing very strong data with several of these agents filgotinib—I mentioned upadacitinib.
So, I'm thinking that as more of this high quality data starts to appear, and as clinicians gain more experience using their medications and, indeed, have pretty good safety results, with the drugs that they're going tend to be more comfortable and interested in using them.
I can tell you that patients are very interested in the idea of once a day oral. Especially, for example, I live in Seattle and, I work with people that work for businesses where they have to do a lot of travel, getting through TSA, worrying about and not having to worry about refrigeration at the other end of the line. These are things that are important. These lifestyle considerations if you will, are important for people so having an effective oral medication is going to be important.