Latest news with #JAK
Medscape
6 days ago
- Health
- Medscape
Infections Common in IBD, Rates Vary by Treatment
TOPLINE: Patients with inflammatory bowel disease (IBD) experienced higher rates of mild and moderate infections. Women, smokers, those with multiple comorbidities, and those with exposure to certain IBD medications showed significantly higher rates of infections. METHODOLOGY: Researchers conducted a prospective observational study (June 2020 to July 2021) to evaluate the incidence of and risk factors for mild, moderate, and severe infections in 629 patients (mean age, 48.3 years; 58.2% women) with IBD who used an established remote monitoring platform for IBD management. They used the Patient-Reported Infections Questionnaire, a validated seven-item tool with a 3-month recall period, to collect data on 15 infection categories, including respiratory tract, urinary tract, and skin conditions and COVID-19. The presence or absence of disease activity was confirmed using a combination of monitoring questionnaire scores for patient-reported disease activity and faecal calprotectin levels. The severity of infection was categorised on the basis of the type and route of treatment as mild (self-limiting or requiring topical treatment), moderate (requiring oral treatment), or severe (requiring hospitalisation and/or intravenous treatment). Exposure to different medications, alone or in combination, was also assessed. TAKEAWAY: Overall, 991 infections were reported during 573.8 person-years of follow-up, with an overall incidence rate (IR) of 172.7 per 100 person-years, predominantly comprising mild (68%; IR, 117.5 per 100 person-years) and moderate (29.5%; IR, 50.9 per 100 person-years) infections. Women demonstrated significantly higher rates of infections than men (IR ratio [IRR], 1.70; P < .001), with increased rates of infections among current smokers vs non-smokers (IRR, 1.43; P = .004). Patients with a Charlson Comorbidity Index score > 2 had significantly higher rates of infections than those with lower scores (IRR for all infections, 1.69; P = .031). Glucocorticoid use more than doubled the rates of infections (IRR, 2.02; P = .033), and compared with no treatment, the use of JAK inhibitors, immunomodulator monotherapy, anti-TNF monotherapy, and combination therapy with anti-TNF and immunomodulators were associated with increased rates of infections. IN PRACTICE: "Clinicians should adopt a holistic approach that includes vigilant monitoring, preferably using validated tools, such as the PRIQ [Patient-Reported Infections Questionnaire], to identify patients with frequent mild or moderate infections. In addition, proactive application of preventive strategies, like vaccination, optimizing nutritional status, counselling for lifestyle modifications, and careful selection of therapies, should be used to reduce infection risk," the authors of the study wrote. SOURCE: This study was led by Ashkan Rezazadeh Ardabili, MD, Department of Gastroenterology and Hepatology, Maastricht University Medical Centre+, Maastricht, the Netherlands. It was published online on July 09, 2025, in the Journal of Crohn's and Colitis. LIMITATIONS: The study's 1‐year follow‐up coincided with COVID‐19 public health measures, likely underestimating overall rates of infections. This study was underpowered to precisely assess rare outcomes, and its real‐world design limited the control over the distribution of medication groups, especially when stratifying the analysis by IBD subtype. DISCLOSURES: This study was supported in part by an investigator-initiated research grant from Takeda. Some authors reported receiving grants, non-financial support, and research prizes and serving as speaker, advisor, and/or principal investigator for various institutions and pharmaceutical companies, including Takeda. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Medscape
11-07-2025
- Health
- Medscape
Good News for Tofacitinib in Recent Study of Acute Severe UC
A head-to-head comparison of the JAK inhibitor drug tofacitinib and chimeric monoclonal antibody infliximab in the treatment of acute severe ulcerative colitis (ASUC) shows that, contrary to concerns, tofacitinib is not associated with worse postoperative complications and in fact may reduce the risk of the need for colectomy. 'Tofacitinib has shown efficacy in managing ASUC, but concerns about postoperative complications have limited its adoption,' reported the authors in research published in Clinical Gastroenterology and Hepatology. 'This study shows that tofacitinib is safe and doesn't impair wound healing or lead to more infections if the patient needs an urgent colectomy, which is unfortunately common in this population,' senior author Jeffrey A. Berinstein, MD, of the Division of Gastroenterology and Hepatology, Michigan Medicine, Ann Arbor, Michigan, told Medscape Medical News. Recent treatment advances for UC have provided significant benefits in reducing the severity of symptoms; however, about a quarter of patients go on to experience flares, with fecal urgency, rectal bleeding, and severe abdominal pain of ASUC potentially requiring hospitalization. The standard of care for those patients is rapid induction with intravenous (IV) corticosteroids; however, up to 30% of patients don't respond to those interventions, and even with subsequent treatment of cyclosporine and infliximab helping to reduce the risk for an urgent colectomy, patients often don't respond, and ultimately, up to a third of patients with ASUC end up having to receive a colectomy. While JAK inhibitor therapies, including tofacitinib and upadacitinib, have recently emerged as potentially important treatment options in such cases, showing reductions in the risk for colectomy, concerns about the drugs' downstream biologic effects have given many clinicians reservations about their use. 'Anecdotally, gastroenterologists and surgeons have expressed concern about JAK inhibitors leading to poor wound healing, as well as increasing both intraoperative and postoperative complications, despite limited data to support these claims,' the authors wrote. To better understand those possible risks, first author Charlotte Larson, MD, of the Department of Internal Medicine, Michigan Medicine, and colleagues conducted a multicenter, retrospective, case-control study of 109 patients hospitalized with ASUC at two centers in the US and 14 in France. Of the patients, 41 were treated with tofacitinib and 68 with infliximab prior to colectomy. Among patients treated with tofacitinib, five (12.2%) received infliximab and four (9.8%) received cyclosporine rescue immediately prior to receiving tofacitinib during the index admission. In the infliximab group, one (1.5%) received rescue cyclosporine. In a univariate analysis, the tofacitinib-treated patients showed significantly lower overall rates of postoperative complications than infliximab-treated patients (31.7% vs 64.7%; odds ratio [OR], 0.33; P = .006). The tofacitinib-treated group also had lower rates of serious postoperative complications (12% vs 28.9; OR, 0.20; P = .016). After adjusting for multivariate factors including age, inflammatory burden, nutrition status, 90-day cumulative corticosteroid exposure and open surgery, there was a trend favoring tofacitinib but no statistically significant difference between the two treatments in terms of serious postoperative complications ( P = .061). However, a significantly lower rate of overall postoperative complications with tofacitinib was observed after the adjustment (odds ratio, 0.38; P = .023). Importantly, a subanalysis showed that the 63.4% of tofacitinib-treated patients receiving the standard FDA-approved induction dose of 10 mg twice daily did indeed have significantly lower rates than infliximab-treated patients in terms of serious postoperative complications (OR, .10; P = .031), as well as overall postoperative complications (OR, 0.23; P = .003), whereas neither of the outcomes were significantly improved among the 36.6% of patients who received the higher-intensity thrice-daily tofacitinib dose ( P = .3 and P = .4, respectively). Further complicating the matter, in a previous case-control study that the research team conducted, it was the off-label, 10 mg thrice-daily dose of tofacitinib that performed favorably and was associated with a significantly lower risk for colectomy than the twice-daily dose (hazard ratio 0.28; P = .018); the twice-daily dose was not protective. Berinstein added that a hypothesis for the benefits overall, with either dose, is that tofacitinib's anti-inflammatory properties are key. 'We believe that lowering inflammation as much as possible, with the colon less inflamed, could be providing the benefit in lowering complications rate in surgery,' he explained. Regarding the dosing, 'it's a careful trade-off,' Berinstein added. 'Obviously, we want to avoid the need for a colectomy in the first place, as it is a life-changing surgery, but we don't want to increase the risk of infections.' In other findings, the tofacitinib group had no increased risk for postoperative venous thrombotic embolisms (VTEs), which is important as tofacitinib exposure has previously been associated with an increased risk for VTEs independent of other prothrombotic factors common to patients with ASUC, including decreased ambulation, active inflammation, corticosteroid use, and major colorectal surgery. 'This observed absence of an increased VTE risk may alleviate some of the hypothetical postoperative safety concern attributed to JAK inhibitor therapy in this high-risk population,' the authors wrote. Overall, the results underscore that 'providers should feel comfortable using this medication if they need it and if they think it's most likely to help their patients avoid colectomy,' Berinstein said. 'They should not give pause over concerns of postoperative complications because we didn't show that,' he said. Commenting on the study, Joseph D. Feuerstein, MD, of the Department of Medicine and Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, noted that, in general, in patients with ASUC who fail on IV steroids, 'the main treatments are infliximab, cyclosporine, or a JAK inhibitor like tofacitinib or upadacitinib, [and] knowing that if someone needs surgery, the complication rates are similar and that pre-operative use is okay is reassuring.' Regarding the protective effect observed with some circumstances, 'I don't put too much weight into that,' he noted. '[One] could speculate that it is somehow related to faster half-life of the drug, and it might not sit around as long,' he said. Feuerstein added that 'the study design being retrospective is a limitation, but this is the best data we have to date.'
Time of India
07-07-2025
- Health
- Time of India
26 years on, war hero revisits Point 5140, relives Kargil memories
1 2 Lucknow: Twenty-six years after the Kargil War , Colonel Rajesh W Adhau, Sena Medal, retraced his steps to Point 5140, a towering peak at 16,800 feet in the rugged Kargil terrain. On July 7, 2025, he stood atop the same ground — famously known as Tiger Hill — where his comrade, Captain Vikram Batra, (Param Vir Chakra-posthumous), sacrificed his life on July 7, 1999, while capturing the strategic peak from enemy forces. The climb, undertaken with the current commanding officer of 13 Jammu and Kashmir Rifles (JAK), Colonel Rajesh Bandhe, and a dozen soldiers, was an emotional one for Adhau. As the Regimental Medical Officer (RMO) of 13 JAK during the 1999 War, Adhau, with just one year of service, faced relentless challenges. Tasked with keeping wounded soldiers alive under heavy shelling, he administered first aid to 97 14 soldiers died in his care, nine from fatal last conversation with Batra, on the evening of July 6, 1999, was a poignant memory — Batra had requested medicine for a headache, unaware of the fate awaiting him the next morning. Reflecting on the trek, Adhau shared, "It was an emotional moment. We fought against all odds to reclaim this land." Upon reaching Point 5140, he called Vishal Batra, Vikram's brother, to share the significance of the moment. Currently, Adhau serves as the head of a Level 3 hospital in Congo under a UN peacekeeping mission. TNN
Business Insider
13-06-2025
- Health
- Business Insider
Merck Animal Health receives EU CVMP positive opinion for NUMELVI
Merck (MRK) Animal, a division of Merck & Co., 'announced that the European Medicines Agency's Committee for Veterinary Medicinal Products issued a positive opinion for NUMELVI Tablets for Dogs. NUMELVI, a once-daily, first-line treatment, will be the only second-generation Janus kinase (JAK) inhibitor indicated for the treatment of pruritus associated with allergic dermatitis including atopic dermatitis and treatment of clinical manifestations of atopic dermatitis in dogs, upon full approval by the European Commission. NUMELVI inhibits the function of JAK1-dependent cytokines involved in itch and inflammation in allergic and atopic dermatitis and is at least 10-fold more selective for JAK1 compared to the other JAK family members. JAK1 selectivity minimizes interference with cytokines involved in hematopoiesis and immune functions dependent on the other JAKs, resulting in a compelling safety profile with proven efficacy in dogs and puppies. Once approved, it will be the only JAK inhibitor that can be used in dogs as young as six months of age. With a once-daily treatment regimen, NUMELVI is clinically effective after the first dose. Treatment with NUMELVI had no impact on immune response to vaccination.'
Fashion Network
12-06-2025
- Business
- Fashion Network
Portuguese sneaker brand JAK grows UK retail footprint with Browns partnership
Portuguese sneaker brand JAK is expanding its presence in the UK. After making its British retail debut in April with an exclusive launch at Selfridges — supported by Rolling People Showroom— the high-end minimalist sneaker label is now set to enter another key fashion destination in the market. Starting August 1, JAK shoes will be available at Browns, one of London's key luxury retailers, both in its Brook Street store and on its e-commerce platform. The selection will include some of JAK's signature models, along with exclusive colourways created for the UK market. "Browns... is a store that shares our passion for timeless design and innovation. This partnership is an important step toward making JAK more accessible to our UK audience," said Isabel Henriques da Silva, who co-founded the brand in 2014 with José Maria Reffóios. Founded a decade ago in Lisbon, JAK currently operates three stores in Portugal: one in Porto and two in Lisbon, with a third Lisbon location scheduled to open at the end of 2024. further expand its physical presence in markets including the United States, Europe and Asia, working in partnership with Rolling People Showroom.
