P190 An international modified Delphi study to understand clinical opinion on current and potential future use of Janus kinase inhibitors in rheumatic and musculoskeletal diseases: global results
Bibliographic record
Abstract
Abstract Background/Aims Janus kinase inhibitors (JAKi) have proven effective for many rheumatic and musculoskeletal diseases (RMDs). Enriched treatment experience for established indications, case reports highlighting broader use and the availability of new and generic JAKi may potentially shift treatment practice. Defining prescribing habits may help predict the future treatment paradigm and understand evidence gaps. This study aimed to capture the global thoughts on JAKi utilization evolution within (1) current indications and (2) new indications where JAKi may have potential place in therapy as identified by unmet medical need, global expert medical opinion and literature evidence using a modified Delphi approach. Methods Systematic/scoping reviews on published literature of JAKi use in RMDs were conducted to inform initial statements alongside committee clinical expertise. A 4 round online modified Delphi study was then conducted with 178 volunteer panellists (clinician’s providing Rheumatology care) from 23 countries. Global experts formed the academic and steering committees. Stable statement consensus or disagreement was a median score of ≥ 7or≤3 from two consecutive rounds on a 1-9 Likert scale, respectively. All statements were presented in ≥ 2 rounds and wording amended based on panellist suggestions, confirmed by committees. Results A total of 138,118,109 and113 panellists completed rounds1-4, respectively. 20 statements reached stable consensus, and 1 statement reached stable disagreement (Table 1), categorised into: Current Uses of JAKi, Potential uses of JAKi beyond currently approved indications, Potential uses of a specific class of JAKi: TYK2 inhibitors or Acquisition and access to JAKi. Clinicians provided 258 statement comments/suggestions. Conclusion This study highlights global expert consensus characterisation of current uses and the evolution of JAKi use in RMDs. Clinicians were in consensus that JAKi have an important role in current indications and generic JAKi may lead to their wider use/broaden the indications for which they are utilised. Clinicians were hesitant to use JAKi without phase 3 RCT data. Work is ongoing to stratify opinion across region, income and treatment practice, and explore barriers to access. This study was sponsored by Pfizer. Pfizer employees and authors designed the study, interpreted data, and wrote the abstract. Analytical support was provided by Momentum data Ltd, funded by Pfizer. Disclosure A. Barkaway: Other; Pfizer Employee. P. Mease: Consultancies; AbbVie, Acelyrin, Amgen, Bristol Myers Squib, Cullinan Biotech, Eli Lilly, Inmagene, Janssen, Moonlake, Novartis, Pfizer, Takeda, UCB. Honoraria; AbbVie, Amgen, Eli Lilly, Janssen, Novartis, Pfizer, UCB. Grants/research support; AbbVie, Acelyrin, Amgen, Bristol Myers Squib, Eli Lilly, Janssen, Novartis, Pfizer, UCB. Other; Genascence. R. Moots: Consultancies; Pfizer. Grants/research support; Novartis. M. Ndosi: Consultancies; Pfizer. Grants/research support; Sanofi, Vifor Pharmaceuticals. Z. Rutter-Locher: Consultancies; Pfizer. M. McLean: Other; Pfizer Employee.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".