Korean J Intern Med.
2023 Jul;38(4):546-556. 10.3904/kjim.2022.369.
Comparative effectiveness of JAK inhibitors and biologic disease-modifying antirheumatic drugs in patients with rheumatoid arthritis
- Cho SK1
- Kim H1
- Song YJ1
- Kim HW1
- Nam E1
- Lee SS2
- Lee HS3
- Park SH4
- Lee YA5
- Park MC6
- Chang SH7
- Kim HA8
- Kwok SK9
- Kim HR10
- Kim HS11
- Yoon BY12
- Uhm WS13
- Kim YG14
- Kim JH15
- Lee J16
- Choi J17
- Sung YK
1
- Affiliations
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- 1Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases and Hanyang University Institute for Rheumatology Research, Seoul, Korea
- 2Division of Rheumatology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
- 3Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea
- 4Division of Rheumatology, Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea
- 5Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
- 6Division of Rheumatology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- 7Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea
- 8Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea
- 9Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- 10Division of Rheumatology, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea
- 11Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea
- 12Division of Rheumatology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea
- 13Uhm’s Rheumatism Clinic, Seoul, Korea
- 14Division of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
- 15Division of Rheumatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea
- 16Division of Rheumatology, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
- 17Division of Rheumatology, Department of Internal Medicine, Busan Saint Mary’s Hospital, Busan, Korea
- KMID: 2544198
- DOI: http://doi.org/10.3904/kjim.2022.369
Abstract
- Background/Aims
We aimed to compare the effectiveness and safety of Janus kinase inhibitors (JAKi) vs. biologic disease- modifying antirheumatic drugs (bDMARD) in Korean patients with rheumatoid arthritis (RA) who had an inadequate response to conventional synthetic DMARDs.
Methods
A quasi-experimental, multi-center, prospective, non-randomized study was conducted to compare response rates between JAKi and bDMARDs in patients with RA naïve to targeted therapy. An interim analysis was performed to estimate the proportion of patients achieving low disease activity (LDA) based on disease activity score (DAS)–28– erythroid sedimentation rate (ESR) (DAS28-ESR) at 24 weeks after treatment initiation and to evaluate the development of adverse events (AEs).
Results
Among 506 patients enrolled from 17 institutions between April 2020 and August 2022, 346 (196 JAKi group and 150 bDMARD group) were included in the analysis. After 24 weeks of treatment, 49.0% of JAKi users and 48.7% of bDMARD users achieved LDA (p = 0.954). DAS28-ESR remission rates were also comparable between JAKi and bDMARD users (30.1% and 31.3%, respectively; p = 0.806). The frequency of AEs reported in the JAKi group was numerically higher than that in the bDMARDs group, but the frequencies of serious and severe AEs were comparable between the groups.
Conclusions
Our interim findings reveal JAKi have comparable effectiveness and safety to bDMARDs at 24 weeks after treatment initiation.
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