PMID- 37334513 OWN - NLM STAT- MEDLINE DCOM- 20230711 LR - 20230803 IS - 2005-6648 (Electronic) IS - 1226-3303 (Print) IS - 1226-3303 (Linking) VI - 38 IP - 4 DP - 2023 Jul TI - Comparative effectiveness of JAK inhibitors and biologic disease-modifying antirheumatic drugs in patients with rheumatoid arthritis. PG - 546-556 LID - 10.3904/kjim.2022.369 [doi] AB - 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 naive 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. CONCLUSION: Our interim findings reveal JAKi have comparable effectiveness and safety to bDMARDs at 24 weeks after treatment initiation. FAU - Cho, Soo-Kyung AU - Cho SK AD - Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases and Hanyang University Institute for Rheumatology Research, Seoul, Korea. FAU - Kim, Hyoungyoung AU - Kim H AD - Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases and Hanyang University Institute for Rheumatology Research, Seoul, Korea. FAU - Song, Yeo-Jin AU - Song YJ AD - Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases and Hanyang University Institute for Rheumatology Research, Seoul, Korea. FAU - Kim, Hye Won AU - Kim HW AD - Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases and Hanyang University Institute for Rheumatology Research, Seoul, Korea. FAU - Nam, Eunwoo AU - Nam E AD - Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases and Hanyang University Institute for Rheumatology Research, Seoul, Korea. FAU - Lee, Shin-Seok AU - Lee SS AD - Division of Rheumatology, Department of Internal Medicine, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea. FAU - Lee, Hye-Soon AU - Lee HS AD - Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea. FAU - Park, Sung-Hoon AU - Park SH AD - Division of Rheumatology, Department of Internal Medicine, Daegu Catholic University School of Medicine, Daegu, Korea. FAU - Lee, Yeon-Ah AU - Lee YA AD - Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyung Hee University, Seoul, Korea. FAU - Park, Min-Chan AU - Park MC AD - Division of Rheumatology, Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. FAU - Chang, Sung Hae AU - Chang SH AD - Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University College of Medicine, Cheonan, Korea. FAU - Kim, Hyoun-Ah AU - Kim HA AD - Department of Rheumatology, Ajou University School of Medicine, Suwon, Korea. FAU - Kwok, Seung-Ki AU - Kwok SK AD - Division of Rheumatology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea. FAU - Kim, Hae-Rim AU - Kim HR AD - Division of Rheumatology, Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea. FAU - Kim, Hyun-Sook AU - Kim HS AD - Division of Rheumatology, Department of Internal Medicine, Soonchunhyang University Seoul Hospital, Seoul, Korea. FAU - Yoon, Bo Young AU - Yoon BY AD - Division of Rheumatology, Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea. FAU - Uhm, Wan-Sik AU - Uhm WS AD - Uhm's Rheumatism Clinic, Seoul, Korea. FAU - Kim, Yong-Gil AU - Kim YG AD - Division of Rheumatology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. FAU - Kim, Jae Hoon AU - Kim JH AD - Division of Rheumatology, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea. FAU - Lee, Jisoo AU - Lee J AD - Division of Rheumatology, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea. FAU - Choi, Jeongim AU - Choi J AD - Division of Rheumatology, Department of Internal Medicine, Busan Saint Mary's Hospital, Busan, Korea. FAU - Sung, Yoon-Kyoung AU - Sung YK AD - Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases and Hanyang University Institute for Rheumatology Research, Seoul, Korea. LA - eng GR - Patient-Centered Clinical Research Coordinating Center/ GR - HI19C0481/Ministry of Health and Welfare/ GR - HC19C0052/Ministry of Health and Welfare/ PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20230620 PL - Korea (South) TA - Korean J Intern Med JT - The Korean journal of internal medicine JID - 8712418 RN - 0 (Janus Kinase Inhibitors) RN - 0 (Antirheumatic Agents) RN - 0 (Biological Products) SB - IM MH - Humans MH - *Janus Kinase Inhibitors/adverse effects MH - Prospective Studies MH - Drug Therapy, Combination MH - *Antirheumatic Agents/adverse effects MH - *Arthritis, Rheumatoid/diagnosis/drug therapy MH - *Biological Products/adverse effects PMC - PMC10338257 OTO - NOTNLM OT - Comparative effectiveness research OT - Janus kinase inhibitor OT - Rheumatoid arthritis OT - Safety OT - Tumor necrosis factor inhibitors COIS- Conflicts of interest The authors disclose no conflicts. EDAT- 2023/06/19 06:42 MHDA- 2023/07/11 06:42 PMCR- 2023/07/01 CRDT- 2023/06/19 03:44 PHST- 2022/11/28 00:00 [received] PHST- 2023/04/25 00:00 [accepted] PHST- 2023/07/11 06:42 [medline] PHST- 2023/06/19 06:42 [pubmed] PHST- 2023/06/19 03:44 [entrez] PHST- 2023/07/01 00:00 [pmc-release] AID - kjim.2022.369 [pii] AID - kjim-2022-369 [pii] AID - 10.3904/kjim.2022.369 [doi] PST - ppublish SO - Korean J Intern Med. 2023 Jul;38(4):546-556. doi: 10.3904/kjim.2022.369. Epub 2023 Jun 20.