Do you still plan to offer tofacitinib to RA patients over 65 if they have one or more additional CV risk factors?  

I would consider offering tofacitinib (or another JAK inhibitor) to patients over 65 with an additional CV risk factor, but only as a last resort after all other options have been exhausted.

My first choice in these patients will obviously be TNFi-biologic. If we have an incomplete responder to TNFi, or someone with an intolerable adverse event to TNFi, then Jak inhibitor vs. non-TNF biologic are reasonable options to discuss risks and benefits with the patient and approach this with a ...