How would you approach management of a patient with ankylosing spondylitis who was doing well on tofacitinib, but experienced a STEMI while on therapy?

This is an excellent question and complex clinical scenario. The patient is HLA-B27 positive with sacroiliitis, peripheral arthritis, and uveitis, and has previously failed two TNF inhibitors but experienced STEMI while on JAKi.

We have the option to switch to IL-17i but we know IL-17- do not prevent...