Reduced versus standard dosing of Janus kinase inhibitors in rheumatoid arthritis: a propensity score–matched real-world study accounting for poor prognostic factors
Authors' conclusion
In patients with preserved renal function, reduced-dose JAKi initiation was associated with 24-month treatment persistence comparable with standard dosing.
Study context
- Population
- Patients with rheumatoid arthritis (RA) initiating Janus kinase inhibitors (JAKi) 2013–2025, Japanese real-world registry; primary analyses in preserved renal function
- Participants
- 1,135 patients
- Exposure
- Standard-dose vs reduced-dose JAKi initiation
- Outcome
- Drug retention, matched cohort with preserved renal function
- Follow-up
- 24 months
Methodological detailsmulticentre, observational, real-world registry, propensity score matching, prespecified stratification by poor prognostic factor (PPF) burden (0-2 vs 3-4)
- Multicentre
- Observational
- Real-world registry
- Propensity score matching
- Prespecified stratification by PPF burden (0-2 vs 3-4)
Main finding
As reported in the abstract
- 24-month drug retention comparable between standard-dose and reduced-dose JAKi
- Matched cohort
Observational data: associations, not effects.
Further findings
Disease activity
- Improved similarly in both groups
GC use
- Remained low without compensatory escalation
Drug retention by PPF burden (subgroup)
- Reduced dosing comparable in low PPF burden; standard-dose more favourable persistence with multiple PPFs
Drug retention in reduced renal function (supportive analysis)
- Standard dosing associated with higher drug retention
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
Reduced versus standard dosing of Janus kinase inhibitors in rheumatoid arthritis: a propensity score–matched real-world study accounting for poor prognostic factors. Ann Rheum Dis. Published 28 April 2026. doi:10.
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