BSR 2025 Monitoring Thresholds — SCE Rheumatology MCQ
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Correct answer: E — Use a JAK inhibitor only if no suitable alternative exists after individualised risk assessment
Explanation lettering: D = shown as A · A = shown as B · B = shown as D
E is correct. MHRA restrictions apply across licensed JAK inhibitors. People aged 65 or older, current or past long-term smokers, and those with cardiovascular or malignancy risk should receive one only when no suitable alternative is available; VTE and serious-infection risks also require assessment. A incorrectly limits a class warning to tofacitinib. B invents a combination-dependent risk. C treats route of administration as cardiovascular protection. D substitutes unproven aspirin mitigation for treatment selection and ignores malignancy and infection. This is not an absolute ban: after alternatives, disease severity and patient values are reviewed, a JAK inhibitor may still be appropriate with risk-factor optimisation and surveillance.
Reference: MHRA: JAK inhibitors — measures to reduce cardiovascular, malignancy, VTE, infection and mortality risks: 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