Effectiveness of TNF-inhibitors, abatacept, IL6-inhibitors and JAK-inhibitors in 31,846 patients with rheumatoid arthritis in 19 registers from the “JAK-pot” collaboration

Research output: Contribution to journalArticlepeer-review

Abstract

Background:
JAK-inhibitors (JAKi), recently approved in rheumatoid arthritis (RA), have changed the landscape of treatment choices. We aimed to compare the effectiveness of four current second-line therapies of RA with different modes of action, since JAKi approval, in an international collaboration of 19 registers.
Methods:
In this observational cohort study, patients initiating tumour necrosis factor inhibitors (TNFi), interleukin-6 inhibitors (IL-6i), abatacept (ABA) or JAKi were included. We compared the effectiveness of these treatments in terms of drug discontinuation and CDAI response rates at one year. Analyses were adjusted for patient, disease and treatment characteristics, including lines of therapy, and accounted for competing risk.
Results:
We included 31,846 treatment courses: 17,522 TNFi, 2,775 ABA, 3,863 IL-6i and 7,686 JAKi. Adjusted analyses of overall discontinuation were similar across all treatments. The main single reason of stopping treatment was ineffectiveness. Compared to TNFi, JAKi were less often discontinued for ineffectiveness (adjusted hazard ratio (aHR) 0.75, 95%CI: 0.67 to 0.83), as was IL-6i (aHR 0.76, 0.67 to 0.85), and more often for adverse events (aHR 1.16, 95%CI: 1.03 to 1.33). Adjusted CDAI response rates at one year were similar between TNFi, JAKi and IL-6i and slightly lower for ABA.
Conclusion
The adjusted overall drug discontinuation and one-year response rates of JAKi and IL-6i were similar to those observed with TNFi. Compared to TNFi, JAKi were more often discontinued for adverse events and less for ineffectiveness, as were IL-6i.
Original languageEnglish
JournalAnnals of the rheumatic diseases
DOIs
Publication statusPublished - 12 Sept 2022

Fingerprint

Dive into the research topics of 'Effectiveness of TNF-inhibitors, abatacept, IL6-inhibitors and JAK-inhibitors in 31,846 patients with rheumatoid arthritis in 19 registers from the “JAK-pot” collaboration'. Together they form a unique fingerprint.

Cite this