Real-world utilisation and switching between Janus kinase inhibitors in Australian patients with rheumatoid arthritis in the OPAL dataset
Authors' conclusion
In this large analysis of Australian real-world practice separated by line of therapy, treatment persistence for JAKi was high overall subject to differential follow-up, but declined in later lines. JAKi to JAKi switching was observed across all lines of therapy.
Study context
- Population
- Adults with rheumatoid arthritis (RA) initiating a Janus kinase inhibitors (JAKi) between 1 October 2015 and 30 September 2021; OPAL dataset, EMRs from 112 rheumatologists around Australia
- Participants
- 3,662 / 1,875 / 1,814
- Exposure
- Tofacitinib vs baricitinib vs upadacitinib, by line of therapy
- Tofacitinib (TOF)n = 3,662
- Baricitinib (BARI)n = 1,875
- Upadacitinib (UPA)n = 1,814
- Outcome
- JAKi treatment persistence by line of therapy
Methodological detailsobservational, Kaplan-Meier survival analysis, descriptive statistics
- Observational
- Kaplan-Meier survival analysis
- Descriptive statistics
Main finding
As reported in the abstract
Median persistence, first-line JAKi
Observational data: associations, not effects.
Further findings
Switching after JAKi discontinuation
- JAKi to JAKi switching occurred across all lines of therapy
- Switches to a tumour necrosis factor inhibitor (TNFi) more frequent after first- or second-line JAKi
JAKi monotherapy use
- Monotherapy use at baseline increased with line of therapy; highest at follow-up after switching to another JAKi
Reason for discontinuation
- 'Lack of efficacy' was the most common reason for discontinuing JAKi
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Real-world utilisation and switching between Janus kinase inhibitors in Australian patients with rheumatoid arthritis in the OPAL dataset. Clin Exp Rheumatol. Published 6 November 2023. doi:10.
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