EULARguidelinesUpdatesCampaign_ProfCaporali_edit
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Well, I think that in the EULAR
Recommendation 2016,
JAK inhibitors were inserted
as an effective drug
that is practically the
same level as anti-TNF.
I think this is really very important
for us and for the patient
and I think this is due to the fact
that these drugs
underwent a large program
of randomized control trials.
In particular if you think about
Baricitinib that was really studied
in all the population
of rheumatoid arthritis,
maybe MTXR, maybe TNF-IR,
maybe in combination,
maybe in monotherapy,
so all these trials allow
the committee of the EULAR
to insert this kind of drug
at the same level of anti-TNF.
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Well, I think that in my experience
this decision was absolutely right
and that having this new drug
for our patients was really important
both for those patients
that were, I mean...
not responding to classical
biological drugs,
but also for naïve patients
because for our patients,
for the first time having a drug
that was an oral drug
so not the subcut drug
was really very important.
And also another very important
situation in our clinical practice
was the speed of this drug
because you can see that
in a couple of days patients
experience improvement
in pain and in the symptoms
of rheumatoid arthritis.
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Well, I think that the new
EULAR Recommendations
are very similar to the old one.
There have been some important,
even if small, changes.
Probably, one of the most striking
change was the fact that
when you think about JAK inhibitors
in these guidelines,
the older recommendation told us
that the actual clinical practice
was to use in the first line
anti-TNF, a biological drug
while now this kind of statement
has been cancelled.
So nowadays, the JAK inhibitors
are at the same level at all
for all the patients with rheumatoid
arthritis, also for naïve patients.
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I think that it is correct because
starting from the last
Recommendation 2016 up to now,
there have been many papers
published on different JAK inhibitors
and all these papers
went in the same direction.
So we now are more confident
about the efficacy and the safety
of these new compounds and also
for example for Baricitinib,
we can see a number of papers
addressing the long-term
efficacy and safety of this drug
coming from the observational
long-term extension trial
in which you can clearly see
that the efficacy may be
observed in the long run and also
the safety is consistent with the first
I mean, information that we have
been informed by the trials.
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