AI Article Synopsis
- This study analyzed factors affecting the retention of Janus kinase inhibitors (JAKi) like baricitinib (BAR) and tofacitinib (TOF) in rheumatoid arthritis (RA) patients across multiple centers.
- It found that the main reasons for discontinuation were ineffectiveness (22.3%), toxic adverse events (13.3%), non-toxic reasons (7.2%), with no discontinuations due to remission.
- Key risk factors for discontinuation included a history of anti-IL-6R ineffectiveness, age (≥ 75 years), high doses of prednisone (≥ 5 mg/day), and being female; while prior treatments and the type of JAKi did not significantly impact discontinu
Article Abstract
This multi-center, retrospective study aimed to clarify the factors affecting drug retention of the Janus kinase inhibitors (JAKi) including baricitinib (BAR) and tofacitinib (TOF) in patients with RA. Patients were as follows; females, 80.6%; age, 60.5 years; DAS28-ESR, 4.3; treated with either BAR (n = 166) or TOF (n = 185); bDMARDs- or JAKi-switched cases (76.6%). The reasons for drug discontinuation were classified into four major categories. The drug retention was evaluated at 24 months using the Kaplan-Meier method and multivariate Cox proportional hazards modelling adjusted by confounders. Discontinuation rates for the corresponding reasons were as follows; ineffectiveness (22.3%), toxic adverse events (13.3%), non-toxic reasons (7.2%) and remission (0.0%). Prior history of anti-interleukin-6 receptor antibody (aIL-6R) ineffectiveness significantly increased the risk of treatment discontinuation due to ineffectiveness (p = 0.020). Aging (≥ 75 years) (p = 0.028), usage of PSL ≥ 5 mg/day (p = 0.017) and female sex (p = 0.041) significantly increased the risk of treatment discontinuation due to toxic adverse events. Factors not associated with treatment discontinuation were: number of prior bDMARDs or JAKi, concomitant MTX usage, difference of JAKi, and prior use of TNF inhibitor, CTLA4-Ig or other JAKi.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8742057 | PMC |
| http://dx.doi.org/10.1038/s41598-021-04075-0 | DOI Listing |
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