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Comparative analysis of hematological changes in patients with rheumatoid arthritis treated with different Janus

Soo Min Ahn1, Ji Seon Oh2, Yong-Gil Kim1

  • 1Department of Rheumatology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Journal of Rheumatic Diseases
|March 27, 2026
PubMed
Abstract

Insights

Baricitinib increased platelet counts in rheumatoid arthritis patients, while all Janus kinase (JAK) inhibitors reduced neutrophil counts. This highlights differing adverse event profiles for JAK inhibitors in RA management.

Area of Science:

  • Rheumatology
  • Pharmacology
  • Hematology

Background:

  • Janus kinase (JAK) inhibitors are crucial for rheumatoid arthritis (RA) treatment.
  • Comparative data on adverse events among different JAK inhibitors is limited.
  • Real-world data on hematological effects of JAK inhibitors in RA is needed.

Purpose of the Study:

  • To compare the hematological effects of tofacitinib, baricitinib, and upadacitinib in RA patients.
  • To identify differences in adverse event profiles among these JAK inhibitors.
  • To assess factors associated with hematologic alterations during JAK inhibitor therapy.

Main Methods:

  • Retrospective analysis of 552 RA patients treated with JAK inhibitors.
  • Assessment of absolute neutrophil count (ANC) and platelet count at baseline and 6 months.
  • Statistical analysis including logistic regression for hematologic alterations.

Main Results:

  • All JAK inhibitors reduced ANC without significant inter-group differences.
  • Baricitinib significantly increased platelet counts compared to tofacitinib and upadacitinib.
  • Multivariate analysis confirmed baricitinib's association with higher platelet counts.

Conclusions:

  • While all JAK inhibitors reduce ANC, baricitinib uniquely elevates platelet counts.
  • Differences in adverse event profiles necessitate tailored patient monitoring.
  • Understanding these hematological differences is key for optimizing RA management.
Keywords:
Janus kinase inhibitorLeukopeniaRheumatoid arthritisThrombocytosis

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