Evaluation of discontinuation for adverse events of JAK inhibitors and bDMARDs in an international collaboration of rheumatoid arthritis registers (the ‘JAK-pot’ study)
Authors' conclusion
While JAKi overall were not associated with more treatment discontinuations for AEs, subgroup analyses suggest varying patterns with specific JAKi, such as tofacitinib, compared with TNFi.
Study context
- Population
- Patients with RA initiating second-line Janus kinase inhibitor (JAKi), tumour necrosis factor inhibitors (TNFi) or OMA, 17 registers of the 'JAK-pot' collaboration
- Participants
- 46,913 treatment courses
- Exposure
- JAKi vs TNFi vs biologicals with another mode of action
- JAKin = 12,523reference
- TNFin = 23,391
- OMAn = 10,999
- Outcome
- Rate of treatment discontinuation due to adverse events (AEs)
Methodological detailsmulticentre (17 registers), real-world, cause-specific Cox proportional hazard models, unadjusted and adjusted
- Multicentre (17 registers)
- Real-world
- Cause-specific Cox proportional hazard models, unadjusted and adjusted
Main finding
As reported in the abstract
Discontinuation for AEs, adjusted cause-specific hazard
Each group vs JAKiAdjusted cause-specific hazard ratio (95% CI)
TNFi
1.00(0.92–1.10)
OMA
1.11(1.01–1.23)
Observational data: associations, not effects.
Further findings
| Outcome | Adjusted cause-specific HR (95% CI) | |
|---|---|---|
| Discontinuation for AEs by specific JAKiTNFivs tofacitinib | 0.81 (0.71–0.90) | |
| Discontinuation for AEs by specific JAKiTNFivs baricitinib | 1.15 (1.01–1.30) | |
| Discontinuation for AEs, patients 65 or older with ≥1 cardiovascular risk factor (subgroup)TNFivs JAKi | 0.79 (0.65–0.97) | |
| 0.512Adjusted cause-specific hazard ratio (log scale) |
Original publication
Evaluation of discontinuation for adverse events of JAK inhibitors and bDMARDs in an international collaboration of rheumatoid arthritis registers (the ‘JAK-pot’ study). Ann Rheum Dis. Published 12 March 2024. doi:10.
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