Characterization of Second-Line Therapy After First JAK Inhibitor Use: Results From the CorEvitas Rheumatoid...

Area of Science:

• Rheumatology
• Pharmacology
• Real-world evidence

Background:

• Rheumatoid arthritis (RA) management involves sequential therapies.
• Janus kinase inhibitors (JAKi) are a key treatment option.
• Understanding treatment patterns after JAKi initiation is crucial for optimizing patient care.

Purpose of the Study:

• To characterize real-world patients with RA initiating JAK inhibitors.
• To examine factors associated with continuing JAK inhibitors versus switching to another mechanism of action (MoA).

Main Methods:

• Analysis of 197 RA patients from the US CorEvitas RA Registry initiating JAKi.
• Classification of patients into JAKi 'cyclers' (continuing JAKi) or 'switchers' (to another MoA).
• Multivariable logistic regression to identify factors associated with cycling versus switching.

Main Results:

• 72.1% of patients switched therapy, while 27.9% continued JAKi (cyclers).
• Cyclers showed numerically greater improvements in Clinical Disease Activity Index (CDAI) and patient-reported outcomes.
• Hypertension history increased odds of switching; fibromyalgia and prior use of ≥2 biologic DMARDs decreased switching odds.

Conclusions:

• Continuing JAKi (cycling) was associated with better initial response, fibromyalgia history, and extensive prior biologic DMARD use.
• The study's findings provide insights into JAKi treatment patterns in RA.
• Larger studies are needed to confirm effectiveness and influencing factors.