Efficacy and safety of Janus kinase inhibitors in patients with difficult-to-treat rheumatoid arthritis.

IF 1.8 4区医学 Q3 RHEUMATOLOGY

Modern Rheumatology Pub Date : 2024-08-31 DOI:10.1093/mr/roae077

Shohei Anno, Tadashi Okano, Kenji Mamoto, Yutaro Yamada, Koji Mandai, Kazuki Orita, Takahiro Iida, Masahiro Tada, Kentaro Inui, Tatsuya Koike, Hiroaki Nakamura

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引用次数: 0

Abstract

Objectives: This study evaluated the effectiveness of Janus kinase inhibitors (JAKi) in patients with difficult-to-treat rheumatoid arthritis (D2T RA).

Methods: This study included 220 patients with RA who were treated with JAKi. Sixty-two patients were naïve to biological disease-modifying anti-rheumatic drugs (bDMARDs)/JAKi (1st group), 57 patients were failure to one bDMARDs/JAKi (2nd group), and 101 patients were failure to ≥ 2 bDMARDs/JAKi. Of these 101 patients, 25 did not meet the D2T RA criteria (non-D2T RA group) and 76 met the D2T RA criteria (D2T RA group).

Results: : DAS28-ESR was improved in all groups at 24 weeks (1st: p<0.01, 2nd: p<0.01, non-D2T RA: p=0.01, D2TRA: p=0.02), and improvement ratio of DAS28-ESR was not different between DT2RA group and 2nd (p=0.73) or non-D2T RA group (p=0.68). Glucocorticoid use (odds ratios: 8.67; 95% CI: 1.23-60.90; P=0.03) and number of past bDMARD/JAKi uses ≥ 3 (odds ratios: 10.55; 95% CI: 1.39-80.30; P=0.02) were risk factors for DAS28-ESR ≥ 3.2 at 24 weeks in the D2T RA group.

Conclusions: Clinical efficacy of JAKi in D2T RA group did not differ from that in 2nd and non-D2T RA groups. Glucocorticoid use and multiple bDMARD/JAKi failure were poor prognostic factors for D2T RA.

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Janus 激酶抑制剂对难以治疗的类风湿关节炎患者的疗效和安全性。

研究目的本研究评估了 Janus 激酶抑制剂（JAKi）对难以治疗的类风湿关节炎（D2T RA）患者的疗效：这项研究包括220名接受JAKi治疗的RA患者。62名患者初次使用生物改良抗风湿药（bDMARDs）/JAKi（第一组），57名患者使用一种生物改良抗风湿药/JAKi失败（第二组），101名患者使用≥两种生物改良抗风湿药/JAKi失败。在这101名患者中，25人不符合D2T RA标准（非D2T RA组），76人符合D2T RA标准（D2T RA组）：结果：：24周时，所有组别的DAS28-ESR均有所改善（第1组：p结论：D2T RA组的临床疗效更好：D2T RA组JAKi的临床疗效与第二组和非D2T RA组没有差异。使用糖皮质激素和多次使用bDMARD/JAKi失败是D2T RA的不良预后因素。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Modern Rheumatology RHEUMATOLOGY-

CiteScore

4.90

自引率

9.10%

发文量

146

审稿时长

1.5 months

期刊介绍： Modern Rheumatology publishes original papers in English on research pertinent to rheumatology and associated areas such as pathology, physiology, clinical immunology, microbiology, biochemistry, experimental animal models, pharmacology, and orthopedic surgery. Occasional reviews of topics which may be of wide interest to the readership will be accepted. In addition, concise papers of special scientific importance that represent definitive and original studies will be considered. Modern Rheumatology is currently indexed in Science Citation Index Expanded (SciSearch), Journal Citation Reports/Science Edition, PubMed/Medline, SCOPUS, EMBASE, Chemical Abstracts Service (CAS), Google Scholar, EBSCO, CSA, Academic OneFile, Current Abstracts, Elsevier Biobase, Gale, Health Reference Center Academic, OCLC, SCImago, Summon by Serial Solutions