Impact of drug-drug interaction of janus kinase (JAK) inhibitors, CYP enzyme inhibitors and OAT3 inhibitors on persistence and infection rates in patients with autoimmune rheumatic diseases
Authors' conclusion
Concomitant use of strong CYP3A4, and CYP2C19 inhibitors with JAK inhibitors significantly increases the risk of discontinuation of treatment and infectious complications in patients with AIRDs.
Study context
- Population
- Patients with RA, PsA and atopic dermatitis treated with JAKi in 2021–2023
- Participants
- 7,591 patients
- Exposure
- Concomitant use of strong CYP3A4, CYP2C19 or OAT3 inhibitors with JAKi vs JAKi without them
- Outcome
- Discontinuation of treatment and infectious complications
Methodological detailsNational Health Insurance Research Database, Cox proportional hazards models, adjusted for age, gender, other infectious and concomitant steroids or MTX
- National Health Insurance Research Database
- Cox proportional hazards models, adjusted for age, gender, other infectious and concomitant steroids or MTX
Main finding
As reported in the abstract
Treatment discontinuation (tofacitinib and baricitinib) with strong CYP3A4 or CYP2C19 inhibitors
Increased risk of treatment discontinuation for tofacitinib and baricitinib
from 41% to 144%
Observational data: associations, not effects.
Safety
Pneumonia
- Risk increased with strong CYP2C19 inhibitors with all JAKi and CYP3A4 inhibitors with tofacitinib
Urinary tract infection
- Risk increased with strong CYP2C19 inhibitors with tofacitinib or baricitinib
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Impact of drug-drug interaction of JAK inhibitors, CYP enzyme inhibitors and OAT3 inhibitors on persistence and infection rates in patients with autoimmune rheumatic diseases. Joint Bone Spine. Published 17 October 2025. doi:10.
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