Comparative effectiveness of biological disease-modifying antirheumatic drugs and Janus kinase inhibitor monotherapy in rheumatoid arthritis
Authors' conclusion
In the analysis with IPW to reduce selection bias, IL-6Ri monotherapy was superior to TNFi monotherapy in terms of effectiveness and drug retention.
Study context
- Population
- Patients with RA initiating bDMARD/Janus kinase inhibitor (JAKi) monotherapy without csDMARDstreatment courses in 635 patients
- Participants
- 849 patients
- Exposure
- IL-6Ri, CTLA4Ig or JAKi monotherapy vs TNFi monotherapy
- Outcome
- Change in DAS28-ESR
- Follow-up
- 24 weeks
Methodological detailspropensity score-based inverse probability weighting, linear mixed-effect models, inverse probability weighting (IPW) Cox proportional hazards models
- Propensity score-based inverse probability weighting
- Linear mixed-effect models
- IPW Cox proportional hazards models
Main finding
As reported in the abstract
week 24
Difference (95% CI)
IL-6Rivs TNFi
−0.93(−1.20 to −0.66)
CTLA4Igvs TNFi
−0.20(−0.48 to 0.08)
JAKivs TNFi
−0.25(−0.67 to 0.16)
Observational data: associations, not effects.
Further findings
| Outcome | HR (CI) | P value | |
|---|---|---|---|
| Overall drug discontinuationIL-6Rivs TNFi | 0.55 (0.39–0.78) | P = 0.001 | |
| 0.20.5125Hazard ratio (log scale) |
Overall drug discontinuation
- Similar retention rates for CTLA4Ig and JAKi vs TNFi
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Comparative effectiveness of biological disease-modifying antirheumatic drugs and Janus kinase inhibitor monotherapy in rheumatoid arthritis. Rheumatology (Oxford). Published 21 November 2023. doi:10.
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