Impact of concomitant methotrexate on janus kinase (JAK) inhibitors in rheumatoid arthritis-associated interstitial lung disease: a retrospective single-centre study from the KEIO-RA cohort
Authors' conclusion
In RA-ILD, our study found no significant differences in the effectiveness of JAK inhibitors for both ILD and arthritis, retention, and safety, with or without MTX.
Study context
- Population
- Consecutive RA-ILD patients treated with JAKi in the KEIO-RA cohort (2013–2025)
- Participants
- 86 treatment courses
- Exposure
- JAKi with concomitant methotrexate (MTX) vs JAKi without MTX
- MTXn = 23
- Outcome
- JAK inhibitor retention rates for 24 months
- Follow-up
- 24 months
Methodological detailssingle-centre, longitudinal cohort, consecutive patients, multivariable analysis
- Single-centre
- Longitudinal cohort
- Consecutive patients
- Multivariable analysis
Main finding
As reported in the abstract
JAKi retention rate
P = 0.43
- Overall 24-month retention rate
- 42.3%
Observational data: associations, not effects.
Secondary outcomes
KL-6, baseline to follow-up (courses on therapy ≥12 months)
- MTX: 309.0 to 324.0 U/mL
- P = 1.00
- non-MTX: 525.0 to 507.0 U/mL
- P = 0.57
- No significant difference between groups
%FVC, baseline to follow-up (courses on therapy ≥12 months)
- MTX: 96.9% to 96.7%
- P = 0.56
- non-MTX: 80.6% to 82.0%
- P = 0.88
- No significant difference between groups
HRCT score, baseline to follow-up (courses on therapy ≥12 months)
- MTX: 4 to 3
- P = 0.72
- non-MTX: 4 to 4
- P = 0.81
- No significant difference between groups
Arthritis improvement and GC dose reduction
- No significant difference between MTX and non-MTX groups
Predictor of discontinuation (multivariable analysis)
- Prior exposure to multiple bDMARDs or JAKi independently predicted discontinuation
Original publication
Impact of concomitant methotrexate on JAK inhibitors in rheumatoid arthritis-associated interstitial lung disease: a retrospective single-centre study from the KEIO-RA cohort. Clin Exp Rheumatol. Published 21 September 2025. doi:10.
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