1. Are JAK inhibitors more effective than biologics for treating ankylosing spondylitis?
3. Can I stay on top of recommended vaccines while taking a JAK inhibitor?
4. JAK inhibitors are so new — how do we know they’re safe?
5. Should I be worried about the black box warning on all JAK inhibitors?
2. Can JAK inhibitors be taken with other ankylosing spondylitis medications?
FAQs About JAK Inhibitors for Ankylosing Spondylitis
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6. Will I be able to afford this medication?
7. Do I need to take this medication forever?
5. JAK inhibitors are new. Are they safe?
Biologics and JAK inhibitors have demonstrated (using a clinical measuring tool) about the same efficacy rate, says Dubreuil. Efficacy is defined as a 40% improvement in at least three out of four main areas of treatment impact, without any worsening in the remaining area, she says.
Rare is the child who will willingly roll up their sleeve for an injection. And chances are, you aren’t looking forward to the jab, either. While an injection takes some getting used to, many parents are reassured by the fact that the medication is safe, seems to have few side effects, and is effective, says Vij. Another bonus: The biologic doesn’t require frequent lab monitoring and blood draws — something that also requires needles — not to mention extra appointments, which can be time consuming, says Kwatra. Your doctor will give you instructions on how to administer the injection, find the proper dosage, and store the medication.
1. What if my child is afraid of needles?
Due to the risks of drug interactions or side effects, a JAK inhibitor is typically prescribed on its own, not in combination with other treatments like NSAIDs or biologics.
You aren’t the only one who balks at the idea of giving yourself an injection. Many people are so satisfied with the results, though, that the benefits outweigh the negatives, says Kwatra. Your doctor will also give you instructions on how to use the syringe or pen, as well as how to store the medication. Another benefit: Unlike other meds for atopic dermatitis, dupilumab doesn’t require blood work, which cuts down on injections aside from the biologic, he says.
1. What if I’m afraid of needles?
JAK inhibitors can increase your risk of infection, which makes vaccinations especially important. “I recommend everyone gets their vaccines before we start treatment,” Bose emphasizes.
Even though JAK inhibitors are a new treatment for ankylosing spondylitis, they’ve been used since 2012 to treat RA, another type of inflammatory arthritis. “All drugs have risks and side effects,” says Bose. But not treating or undertreating your disease also poses risks.
4. JAK inhibitors are so new — How do we know they’re safe?
There can be some side effects from using biologics for atopic dermatitis, but in general, there aren’t very many, says Vij. You may experience some pain or swelling around the injection site, for example. You shouldn’t use dupilumab or tralokinumab-Idrm if you are allergic to the medication or any of the ingredients in the injection. (You can ask your pharmacist for a list of what’s in the medications).
3. Are there side effects?
While the black box warning may be concerning, “The FDA was pretty conservative and wanted to ensure that people are cautious,” explains Dubreuil, emphasizing that researchers are continuing to explore the effects of JAK inhibitors. “In a couple years’ time, we’ll have more information — and possibly a differently worded warning.”
List prices for biologics can run into the thousands of dollars, but many private and commercial health insurance plans cover this cost, says Kwatra. (Depending on what type of plan you have and whether you’ve met your deductible, you may have to pay a portion of the cost.) For example, many people with Medicare may pay less than $100 a month for one of these medications, and people with Medicaid may pay less than $10 a month. Even if you don’t have insurance, you may be eligible for a patient assistance program that can help you cover the costs.
4. How much does it cost?
While these drugs are very expensive, as long as you’re eligible to try a JAK inhibitor, most health insurance companies help foot the bill so you’re only responsible for your prescription plan’s copay. If your insurance plan doesn’t cover the cost of JAK inhibitors or you’re having trouble coming up with your copay, each drug manufacturer also offers patient assistance programs to help you save money on your medication.
“Ankylosing spondylitis is a chronic condition,” emphasizes Bose. “It’s hard to say how long you’re going to need medication. Some people require medication for a long time, and some don’t. Some want to taper off, and some would rather not because they’re scared of a relapse.” At the end of the day, it’s important to work with your doctor to discuss your individual circumstances and develop a plan that works best for you.
