Changes in Characteristics of Patients Initiating and Discontinuing Advanced Therapies for Rheumatoid Arthritis Following the Release of Safety Data
Authors' conclusion
Recent safety data significantly affected prescribing practices for advanced therapies, with a reduction in JAKi initiation and an increase in JAKi discontinuation among older patients and those at high cardiovascular risk.
Study context
- Population
- US veterans with rheumatoid arthritis (RA) initiating a tumor necrosis factor inhibitor (TNFi), non-TNFi biologic or JAK inhibitor (JAKi), April 2019 to September 2022 (two 664-day periods before and after January 2021)
- Participants
- 2,111 vs 1,664
- Exposure
- Patients initiating tofacitinib before vs after January 2021; discontinuation of tofacitinib vs TNFi
- Tofacitinib before January 2021n = 2,111reference
- Tofacitinib after January 2021n = 1,664
- Outcome
- Characteristics of patients initiating and discontinuing advanced therapies for RA before and after January 2021
Methodological detailsCox models adjusted for age, sex and duration on therapy, interaction testing in regression models
- Cox models adjusted for age, sex and duration on therapy
- Interaction testing in regression models
Main finding
As reported in the abstract
Characteristics of tofacitinib initiators
Observational data: associations, not effects.
Further findings
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| Discontinuation among active advanced therapy recipientsTofacitinibvs TNFi | 1.18 (1.10–1.26) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
Discontinuation among active advanced therapy recipients
- Higher rate of tofacitinib discontinuation more pronounced in the presence of cardiovascular comorbidities (P < 0.05)
Original publication
Changes in Characteristics of Patients Initiating and Discontinuing Advanced Therapies for Rheumatoid Arthritis Following the Release of Safety Data. Arthritis Care Res (Hoboken). Published 12 January 2024. doi:10.
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