AI Article Synopsis
- The study examined the effectiveness and safety of Janus kinase inhibitors (JAKi) for treating rheumatoid arthritis-associated interstitial lung disease (RA-ILD), an area with limited therapeutic options.
- It included a systematic review of literature and meta-analysis of data from seven observational studies and found that JAKi improved lung function and imaging results in patients with RA-ILD.
- The results indicated that JAKi were generally well tolerated, with a low risk of developing new ILD, and showed similar safety and efficacy to existing treatments like abatacept and rituximab.
Article Abstract
Objective: The treatment of rheumatoid arthritis-associated interstitial lung disease (RA-ILD) remains challenging due to the scarcity of proven effective therapeutic options. This study aimed to investigate the effectiveness and safety of Janus kinase inhibitors (JAKi) in RA-ILD.
Methods: We systematically reviewed the literature to identify studies evaluating the efficacy and safety of JAK inhibitors in RA-ILD. A meta-analysis was performed using the random-effects model.
Results: The literature search identified seven observational studies assessing the safety and efficacy of JAKi in RA-ILD and three studies analyzing the risk of developing de novo ILD in RA patients treated with JAKi. Among 183 patients with RA-ILD, the pooled analysis demonstrated an increase of 2.07 % in %pFVC (95 % CI: 0.57-3.58; p = 0.007) and 3.12 % in %pDLCO (95 % CI: 2.11-4.12; p < 0.001). Thoracic HRCT scans showed improvement in 11 % of patients (95 % CI: 0.01-0.29). The pooled proportion of patients experiencing worsening of pre-existing ILD was 5 % (95 % CI: 0.01-0.11). Adverse events were reported in 14 % of cases (95 % CI: 0.08-0.21), with the frequency of clinically significant infections ranging from 4.5 % to 25 %. The risk of developing de novo ILD in patients receiving JAKi was low, with an incidence rate of 0.20 per 1000 person-years (95 % CI: 0.14-0.25). Comparisons with abatacept and rituximab suggested similar efficacy and safety profiles.
Conclusion: JAKi are well tolerated and might be a viable treatment option for RA-ILD, offering comparable safety and efficacy to abatacept and rituximab.
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| http://dx.doi.org/10.1016/j.autrev.2024.103636 | DOI Listing |
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