JAK inhibitors for the treatment of inflammatory bowel disease: results of an international survey of perceptions, attitudes, and clinical practice

TY - JOUR

T1 - JAK inhibitors for the treatment of inflammatory bowel disease: results of an international survey of perceptions, attitudes, and clinical practice

AU - Honap, Sailish

AU - Irving, Peter M

AU - Samaan, Mark A

N1 - Publisher Copyright: © 2023 Lippincott Williams and Wilkins. All rights reserved.

PY - 2023/11/1

Y1 - 2023/11/1

N2 - BACKGROUND: Janus kinase inhibitors (JAKi) are small molecule drugs with demonstrated efficacy in inflammatory bowel disease (IBD). However, widespread utilisation may be hindered by safety concerns.AIMS: This is the first study assessing risk-benefit perceptions and clinical practices of those using JAKi for IBD.METHODS: A prospective, cross-sectional study was conducted using a 23-item survey distributed to IBD healthcare providers worldwide.RESULTS: Of 385 respondents from 48 countries, 72% were tertiary-centre based and 50% were gastroenterologists with ≥10 years experience. JAKi were commonly used outside market authorisation (31%), though many (17%) were unconfident discussing JAKi risk-benefit profile and 7% had never prescribed JAKi. If venous thromboembolism risks were present, 15% preferentially referred for surgery than initiate JAKi; 21% would do this even if the patient was already anticoagulated. For patients relapsing on dose reduction, 8% would switch treatment rather than dose escalate. Conversely, 45% felt that cardiovascular safety concerns from post-marketing studies were irrelevant to IBD. Despite the lack of detailed, long-term safety data, safety profiles of JAK1-selective drugs were perceived to be favourable to tofacitinib by most (62%).CONCLUSION: The study indicates that while clinical practice appears to be in keeping with international guidance, a significant minority remain deterred by safety concerns.

AB - BACKGROUND: Janus kinase inhibitors (JAKi) are small molecule drugs with demonstrated efficacy in inflammatory bowel disease (IBD). However, widespread utilisation may be hindered by safety concerns.AIMS: This is the first study assessing risk-benefit perceptions and clinical practices of those using JAKi for IBD.METHODS: A prospective, cross-sectional study was conducted using a 23-item survey distributed to IBD healthcare providers worldwide.RESULTS: Of 385 respondents from 48 countries, 72% were tertiary-centre based and 50% were gastroenterologists with ≥10 years experience. JAKi were commonly used outside market authorisation (31%), though many (17%) were unconfident discussing JAKi risk-benefit profile and 7% had never prescribed JAKi. If venous thromboembolism risks were present, 15% preferentially referred for surgery than initiate JAKi; 21% would do this even if the patient was already anticoagulated. For patients relapsing on dose reduction, 8% would switch treatment rather than dose escalate. Conversely, 45% felt that cardiovascular safety concerns from post-marketing studies were irrelevant to IBD. Despite the lack of detailed, long-term safety data, safety profiles of JAK1-selective drugs were perceived to be favourable to tofacitinib by most (62%).CONCLUSION: The study indicates that while clinical practice appears to be in keeping with international guidance, a significant minority remain deterred by safety concerns.

UR - http://www.scopus.com/inward/record.url?scp=85174258693&partnerID=8YFLogxK

U2 - 10.1097/MEG.0000000000002650

DO - 10.1097/MEG.0000000000002650

M3 - Article

C2 - 37724470

SN - 0954-691X

VL - 35

SP - 1270

EP - 1277

JO - European Journal of Gastroenterology and Hepatology

JF - European Journal of Gastroenterology and Hepatology

IS - 11

ER -