Clinical Edge Journal Scan

Real-world efficacy and safety of second-line therapies for RA


 

Key clinical point: The drug discontinuation and 1-year response rates of Janus kinase inhibitors (JAKi), interleukin-6 inhibitors (IL-6i), and abatacept as second-line therapies for rheumatoid arthritis (RA) appeared to be similar to those of tumor necrosis factor-inhibitors (TNFi). However, JAKi and IL-6i were more often discontinued for adverse events and less for ineffectiveness.

Major finding: Compared with TNFi, the 1-year response rate and treatment retention were not significantly different for abatacept, IL-6i, and JAKi, but IL6-i (adjusted hazard ratio [aHR] 0.76; 95% CI 0.67-0.85) and JAKi (aHR 0.75; 95% CI 0.67-0.83) were less frequently discontinued because of inefficacy and often because of adverse events.

Study details: This study evaluated data of 31,846 treatment courses (TNFi: n = 17,522; abatacept: n = 2775; IL-6i: n = 3863; and JAKi: n = 7686) from 19 registers.

Disclosures: The registers were supported by Fundacion Española de Reumatología, the Spanish Medicines and Health Products Agency, and other sources. Several authors reported receiving personal or speaking fees, grants, or honoraria, or serving on speaker’s bureaus for various sources .

Source: Lauper K et al. Effectiveness of TNF-inhibitors, abatacept, IL6-inhibitors and JAK-inhibitors in 31 846 patients with rheumatoid arthritis in 19 registers from the ‘JAK-pot’ collaboration. Ann Rheum Dis. 2022 (Jun 15. Doi: 10.1136/annrheumdis-2022-222586

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