Sustained efficacy of second-line JAK inhibitors in patients with rheumatoid arthritis: insights from the ANSWER cohort
Authors' conclusion
JAKi maintained continuation rates and efficacy in second-line treatment compared with first-line treatment
Study context
- Population
- Patients with RA in an observational multicentre registry in Japan (ANSWER cohort) treated with TNFi, IL-6 inhibitors, CTLA4 or Janus kinase inhibitors (JAKi)
- Participants
- 5,900 treatment courses
- Exposure
- Second-line vs first-line use of bDMARDs and JAKi after failure of initial therapy
- Second-linen = 1,854
- First-linen = 4,046reference
- Outcome
- Drug continuation (CIF for drug discontinuation, remission as competing risk) and efficacy (ΔCDAI, ΔDAS28-CRP)
Methodological detailsmulticentre, observational registry, competing risk analysis (Fine-Gray model), linear mixed model with covariate adjustments
- Multicentre
- Observational registry
- Competing risk analysis (Fine-Gray model)
- Linear mixed model with covariate adjustments
Main finding
As reported in the abstract
Drug discontinuation (CIF), first- vs second-line
- Only JAKi showed no significant difference in cumulative incidence function (CIF) between first- and second-line treatment among TNFi, IL-6 inhibitors, CTLA4 and JAKi
- Competing risk analysis: second-line treatment influenced drug continuation rates for all drugs except JAKi
Observational data: associations, not effects.
Further findings
Efficacy (CDAI and DAS28-CRP trends, linear mixed model)
- JAKi showed similar efficacy as first- and second-line therapy, unlike other drugs
Original publication
Sustained efficacy of second-line JAK inhibitors in patients with rheumatoid arthritis: insights from the ANSWER cohort. Rheumatology (Oxford). Published 20 March 2025. doi:10.
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