Alopecia areata Learning Zone
Transcript: Optimising safe use of JAK inhibitors for alopecia areata
Dr Brittany Craiglow
Interview recorded Mar 2024. All transcripts are created from interview footage and directly reflect the content of the interview at the time. The content is that of the speaker and is not adjusted by Medthority.
So I think before we start a JAK inhibitor, it's important to, you know, to look at the patient in front of us and determine whether or not they may have any preexisting conditions or comorbidities that may increase their baseline risk for some of the things that we think about with JAK inhibitors, like major adverse cardiovascular events, serious infections, thrombosis, and malignancy. Now the rate, importantly the rate of those events in clinical trials for patients with alopecia areata and other dermatologic diseases are very low, but for sure, if a patient has multiple baseline risk factors, the conversation, you know, with them about starting looks a little bit different from the very young healthy person who doesn't have any risk factors.
So once we decide to start treatment, we do do blood monitoring, you know, before treatment you wanna make sure somebody has normal blood counts, liver function, renal function, make sure they haven't been exposed to tuberculosis or hepatitis. And then for baricitinib, we also check lipids. And in follow up, we'll check lipids also about 12 weeks for baricitinib. For ritlecitinib, lipids actually aren't in the package in certain terms of monitoring, but those patients do need a CBC around four weeks to look at lymphocyte and platelet counts. And then beyond that, the monitoring is sort of per your clinical judgement. So I think it, you know, it really depends a lot on the patient, but if they have normal values for me, I might check them three months later and then every six months thereafter. You know, another thing to think about is potential drug-drug interaction. So that's something we want to, you know, evaluate before starting also. And then I think, you know, seeing the patient in follow up, asking a good review of systems, checking their lymph nodes. All these things are sort of just part of good clinical practise, are important when we're treating patients with these medications.
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Developed by EPG Health. This content has been developed independently of the sponsor, Pfizer, who has reviewed the content only for scientific accuracy. EPG Health received funding from the sponsor in order to help provide healthcare professionals with access to the highest quality medical and scientific information, education and associated relevant content.