Presenting JAK inhibitor safety information to dermatology patients

Anthony J. Teixeira, Jessica Q. Duong, Shirley P. Parraga, Steven R. Feldman
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Abstract

Janus Kinase (JAK) inhibitors are treatment options for dermatologic conditions such as atopic dermatitis, psoriasis, vitiligo, and alopecia areata. Guidance on how to counsel patients on these novel treatments is limited. The purpose of this review is to provide options providers can use to discuss JAK inhibitors with dermatology patients. The PubMed database was searched for terms including “dermatology JAK inhibitor safety” and “presenting information to patients.” Relevant literature was selected for inclusion. Black box warnings were placed on JAK inhibitors after a large, controlled trial in rheumatoid arthritis patients did not prove that tofacitinib was as safe as tumor necrosis factor inhibitors; in clinical trials for dermatologic conditions, JAK inhibitors had low risks of serious adverse events. Patient barriers to comprehending treatment information include conflicting information and limited time for discussion of risks. To address these barriers, suggested approaches have included speaking in simple phrases, providing reliable sources, and offering educational materials appropriate for different cultures. When discussing risks, physicians may use anecdotes and frame risks and side effects in ways that decrease anxiety. JAK inhibitors have uncommon severe side effects and related concerns that may be hard for patients to overcome, even when benefits exceed risks. Standard educational approaches can be complemented by anecdotes and framing to help diminish patients' anxiety.

Abstract Image

向皮肤病患者提供JAK抑制剂的安全性信息
Janus 激酶(JAK)抑制剂是特应性皮炎、银屑病、白癜风和斑秃等皮肤病的治疗选择。关于如何指导患者使用这些新型治疗方法的指导非常有限。本综述旨在为医疗工作者提供与皮肤科患者讨论 JAK 抑制剂时可采用的方案。在 PubMed 数据库中搜索了包括 "皮肤科 JAK 抑制剂安全性 "和 "向患者提供信息 "在内的术语。筛选出相关文献进行收录。一项针对类风湿性关节炎患者的大型对照试验未能证明托法替尼与肿瘤坏死因子抑制剂一样安全,因此对JAK抑制剂发出了黑框警告;在针对皮肤病的临床试验中,JAK抑制剂发生严重不良事件的风险较低。患者在理解治疗信息时遇到的障碍包括信息相互矛盾以及讨论风险的时间有限。为解决这些障碍,建议的方法包括用简单的短语说话、提供可靠的信息来源以及提供适合不同文化的教育材料。在讨论风险时,医生可以使用趣闻轶事,并以减少焦虑的方式来描述风险和副作用。JAK 抑制剂具有不常见的严重副作用和相关顾虑,患者可能难以克服这些副作用和顾虑,即使是在获益大于风险的情况下。标准的教育方法可辅以轶事和框架来帮助减轻患者的焦虑。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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CiteScore
0.30
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