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Clinical Outcomes in Patients with Rheumatoid Arthritis After Switching Between Interleukin-6-Receptor Inhibitors and
Anisha B Dua1, Kerri Ford2, Stefano Fiore3
1Division of Rheumatology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA. anisha.dua@northwestern.edu.
Rheumatology and Therapy
|October 31, 2023
Summary
Patients with rheumatoid arthritis (RA) benefit from switching between interleukin-6 receptor inhibitors (IL-6Ri) and Janus kinase inhibitors (JAKi). Both drug classes offer clinical improvements, with distinct mechanisms contributing to efficacy in RA treatment.
Area of Science:
- Rheumatology
- Immunology
- Pharmacology
Background:
- Rheumatoid arthritis (RA) management involves targeted therapies like IL-6 receptor inhibitors (IL-6Ri) and Janus kinase inhibitors (JAKi).
- Understanding treatment response after switching between these drug classes is crucial for optimizing patient care.
Purpose of the Study:
- To evaluate clinical response in RA patients switching between IL-6Ri and JAKi therapies.
- To compare outcomes between patients initiating IL-6Ri after JAKi discontinuation and vice versa.
Main Methods:
- Observational study of adult RA patients switching between IL-6Ri and JAKi.
- Clinical outcomes (CDAI, HAQ, pain, fatigue) assessed at baseline and 6-month follow-up.
- Statistical analysis using linear and logistic regression models.
Main Results:
- No significant differences in continuous outcomes between IL-6Ri and JAKi groups.
- Both groups showed significant proportions achieving low disease activity (LDA) and remission.
- Higher odds of LDA among IL-6Ri initiators with moderate-to-severe RA compared to JAKi initiators.
Conclusions:
- Switching between IL-6Ri and JAKi can lead to improved patient response in RA.
- Distinct mechanisms of action for IL-6Ri and JAKi contribute to clinical benefits upon reciprocal switching.
- Both drug classes are effective follow-on treatments in RA management.
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