Would you avoid use of JAK inhibitors in patients with dermatomyositis with autoantibody subtypes with increased risk of malignancy (TIF1y, NXP2)?

In patients with dermatomyositis and increased malignancy risk autoantibody subtypes (anti-TIF1γ or anti-NXP2), how does concern for malignancy risk influence your use of JAK inhibitors?

• I avoid JAK inhibitors in these patients
• I use JAK inhibitors after thorough malignancy screening and shared decision making
• I would use JAK inhibitors similarly to other dermatomyositis subtypes if clinically indicated
• I prefer alternative steroid sparing agents before considering JAK inhibitors
• Other