Have you used JAK inhibitors with TNF blockade at the same time?

Generally, no. For three reasons:

1. I find the addition of a JAK inhibitor to a TNF inhibitor to be too immunosuppressive with a high risk of infection and/or malignancy.
2. If I am choosing a JAK inhibitor, it would serve to "replace" the TNF inhibitor usually, so I don't see a strong indication to sta...