The impact of glucocorticoids on the efficacy of JAK inhibitors or non-TNF-targeted biologics in RA
Authors' conclusion
JAKi did not show superiority over OMA regarding steroid-sparing effects; however, JAKi yielded higher remission rates. Exposure to GC at 6 months predicted poorer 24-month outcomes.
Study context
- Population
- RA patients with inadequate response to TNF inhibitors (TNFi-IRs)
- Participants
- 299 patients
- Exposure
- JAKi vs non-TNF-targeted bDMARDs (OMA: tocilizumab, abatacept, rituximab) in TNFi-IR RA, and the impact of oral low-dose GC
- JAKin = 161
- OMAn = 138reference
- Outcome
- Good EULAR response
- Follow-up
- 6, 12 and 24 months
Methodological detailssingle-centre, structural equation modeling, competing risks analysis, linear mixed-effects models
- Single-centre
- Structural equation modeling
- Competing risks analysis
- Linear mixed-effects models
Main finding
As reported in the abstract
24 months
GC dosage at 6 months negatively affected the 24-month outcome (β)
−0.456
P = 0.020
Observational data: associations, not effects.
Secondary outcomes
Proportion of GC users · 6 months
P = 0.036
Proportion of GC users · 12 months
P = 0.161
Proportion of GC users · 24 months
P = 0.430
| Outcome | HR | P value |
|---|---|---|
| Treatment discontinuationRates similar | 1.49 | P = 0.34 |
- DAS28-CRP remission · more frequent in JAKi
- P < 0.05
GC dose reduction
- No statistically significant differences between the two groups across any time interval
Original publication
The impact of glucocorticoids on the efficacy of JAK inhibitors or non-TNF-targeted biologics in RA. Rheumatology (Oxford). Published 17 November 2025. doi:10.
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