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Comparative Study
. 2024 Nov 1;63(11):3033-3041.
doi: 10.1093/rheumatology/kead543.

Real-world comparative study of the efficacy of Janus kinase inhibitors in patients with rheumatoid arthritis: the ANSWER cohort study

Shinya Hayashi  1 , Shotaro Tachibana  1 , Toshihisa Maeda  1 , Mai Yamashita  2 , Iku Shirasugi  2 , Yuzuru Yamamoto  2 , Hirotaka Yamada  2 , Takaichi Okano  2 , Keisuke Nishimura  2 , Yo Ueda  2 , Sadao Jinno  2 , Jun Saegusa  2 , Wataru Yamamoto  3 , Koichi Murata  4 , Takayuki Fujii  4 , Kenichiro Hata  5 , Ayaka Yoshikawa  5 , Kosuke Ebina  6 , Yuki Etani  7 , Naofumi Yoshida  8   9 , Hideki Amuro  8 , Motomu Hashimoto  9 , Ryota Hara  10 , Masaki Katayama  11 , Tadashi Okano  12 , Ryosuke Kuroda  1
Affiliations
Comparative Study

Real-world comparative study of the efficacy of Janus kinase inhibitors in patients with rheumatoid arthritis: the ANSWER cohort study

Shinya Hayashi et al. Rheumatology (Oxford). .

Erratum in

Abstract

Objective: This multicentre, retrospective study compared the efficacy and safety of tofacitinib, baricitinib, peficitinib and upadacitinib in real-world clinical settings after minimizing selection bias and adjusting the confounding patient characteristics.

Method: The 622 patients were selected from the ANSWER cohort database and treated with tofacitinib (TOF), baricitinib (BAR), peficitinib (PEF) or upadacitinib (UPA). The patient's background was matched using propensity score-based inverse probability of treatment weighting (IPTW) among four treatment groups. The values of Clinical Disease Activity Index (CDAI), C-reactive protein (CRP), and modified Health Assessment Questionnaire (mHAQ) after drug initiation and the remission or low disease activity (LDA) rates of CDAI at 6 months after drug initiation were compared among the four groups. Further, the predictive factor for TOF and BAR efficacy was analysed.

Results: The retention and discontinuation rates until 6 months after drug initiations were not significantly different among the four JAK inhibitors treatment groups. Mean CDAI value, CDAI remission rate, and CDAI-LDA rate at 6 months after drug initiation were not significantly different among treatment groups. Baseline CDAI (TOFA: OR 1.09, P < 0.001; BARI: OR 1.07, P < 0.001), baseline CRP (TOFA: OR 1.32, P = 0.049), baseline glucocorticoid dose (BARI: OR 1.18, 95% CI 1.01-1.38, P = 0.035), a number of previous biological or targeted synthetic disease-modifying antirheumatic drugs (biological/targeted synthetic DMARDs) (BARI: OR 1.36, P = 0.004) were predictive factors for resistance to CDAI-LDA achievement to JAK inhibitor treatment.

Conclusion: The efficacy and safety of TOF, BAR, PEF and UPA were not significantly different for the treatment of patients with rheumatoid arthritis.

Keywords: baricitinib; peficitinib; rheumatoid arthritis; tofacitinib; upadacitinib.

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