RA- tsDMARDs DI

Question 1

tsDMARDs/JAKis drugs

Answer 1

Tofacitinib (Xeljanz)
Baricitinib (Olumiant)
Upadacitinib (Rinvoq)

Question 2

JAKis MoA

Answer 2

Inhibit JAK enzymes to block transcription of inflammatory genes

Question 3

Xeljanz dosing

Answer 3

IR: 5mg PO BID
XR: 11mg PO QD

Question 4

Olumiant dosing

Answer 4

2mg PO QD

Question 5

Rinvoq dosing

Answer 5

15mg PO QD

Question 6

Xeljanz ADEs

Answer 6

Increased HDL and LDL
HA
UTI
URTI
GI perforation
Anemia
Neutropenia
Skin cancer
PE
Infections

Question 7

Olumiant ADEs

Answer 7

Increased AST/ALT
Nausea
Herpes zoster and other infections
GI perforation
Thrombosis
Infections

Question 8

Rinvoq ADEs

Answer 8

Increased HDL, LDL, TC, and AST/ALT
Nausea
URTI
Skin cancer
GI perforation
Thrombosis
Anemia
Neutropenia
Infections

Question 9

JAKis BBW

Answer 9

Risk of opportunistic infections, lymphomas, other malignancies, thrombosis (DVT, PE, arterial thrombosis)

Question 10

What should you screen for before starting a JAKi?

Answer 10

Latent TB and Hep B infections

Question 11

When to use JAKis based on the guidelines

Answer 11

Moderate-high disease activity despite DMARD monotherapy

Unable to tolerate/CI to csDMARD

Question 12

What to use JAKis with

Answer 12

Can be used alone or in combination with MTX or other NONBIOLOGIC DMARDs