JAK inhibitors in the treatment of adult patients with juvenile idiopathic arthritis: a retrospective monocentric experience
Authors' conclusion
JAKi may represent an effective and safe treatment option for adult JIA patients with low/moderate disease activity, particularly in case of oligoarticular involvement.
Study context
- Population
- Adult patients (≥18 years) with juvenile idiopathic arthritis (JIA) attending a rheumatology transition clinic, treated with JAK inhibitors (JAKi) for at least 3 months
- Participants
- 17 patients
- Exposure
- Baricitinib vs tofacitinib
- Baricitinibn = 8
- Tofacitinibn = 9
- Outcome
- Efficacy (response and disease remission) and safety of JAKi
- Follow-up
- 3 months
Methodological detailsmonocentric
- Monocentric
Main finding
As reported in the abstract
P = 0.294
Patients
- Response, all patients
- 8 (47%)
- Disease remission, all patients
- 4 (23.5%)
Observational data: associations, not effects.
Further findings
Remission by JIA subset · 3 months
- Systemic JIA and enthesitis-related arthritis: no remission
- 0
- Oligoarticular vs polyarticular remission rate (higher, not significantly)
- 37.5% vs. 20%
Remission by active joints at JAKi start (≤1 vs more)
- ≤1 active joint: higher remission rate
- 50% vs. 22.2%
Pre-treatment DAS28-CRP, remission vs still active disease
- Significantly lower in those achieving remission (Mann-Whitney U=4)
- P = 0.010
- DAS28-CRP <3.76 predicting response: sensitivity
- 100%
- DAS28-CRP <3.76 predicting response: specificity (p=0.023)
- 84.6%
Remission by prior ≥2 biological drugs vs fewer
- Lower remission rate with ≥2 prior biologics (p=0.05)
- 9% vs. 66.7%
Safety
Severe arterial hypertension
- One patient on concomitant leflunomide
- 1
Original publication
JAK inhibitors in the treatment of adult patients with juvenile idiopathic arthritis: a retrospective monocentric experience. Clin Exp Rheumatol. Published 16 June 2023. doi:10.
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