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JAK Inhibitor VTE Risk — SCE Rheumatology MCQ

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HardRheumatoid ArthritisJAK Inhibitor VTE RiskSCE Rheumatology

A 69-year-old former heavy smoker with rheumatoid arthritis, previous myocardial infarction and prior venous thromboembolism has active disease after methotrexate. A JAK inhibitor is being considered mainly because the patient prefers tablets. What best reflects current MHRA advice?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Prefer a suitable non-JAK alternative after explicit risk assessment

Explanation lettering: D = shown as B · E = shown as C · C = shown as D · B = shown as E

A is correct. The MHRA warning is class-wide and this patient has several named high-risk features; a JAK inhibitor should be used only when no suitable alternative exists after explicit benefit–risk assessment. B confuses route with safety. C wrongly limits a class warning. D proposes unproven mitigation that does not address malignancy or infection. E invents a time limit after smoking cessation.

Reference: MHRA: JAK inhibitors — measures to reduce major adverse outcomes: https://www.gov.uk/drug-safety-update/janus-kinase-jak-inhibitors-new-measures-to-reduce-risks-of-major-cardiovascular-events-malignancy-venous-thromboembolism-serious-infections-and-increased-mortality