Baseline CRP, Clinical Disease Activity Index, glucocorticoid dose predict resistance to CDAI-low disease activity achievement
By Elana Gotkine HealthDay Reporter
FRIDAY, Dec. 1, 2023 (HealthDay News) — For patients with rheumatoid arthritis, the efficacy and safety of four Janus kinase (JAK) inhibitors is comparable, according to a study published online Nov. 1 in Rheumatology.
Shinya Hayashi, M.D., from the Kobe University Graduate School of Medicine in Japan, and colleagues conducted a multicenter, retrospective study comparing the efficacy and safety of tofacitinib (TOFA), baricitinib (BARI), peficitinib, and upadacitinib in 622 patients in real-world clinical settings. In the four treatment groups, patient backgrounds were matched using propensity score-based inverse probability of treatment weighting.
The researchers found that among the four JAK inhibitor groups, the retention and discontinuation rates until six months after drug initiation did not differ significantly. Furthermore, no differences were seen in mean Clinical Disease Activity Index (CDAI) value, CDAI remission rate, or CDAI-low disease activity (LDA) rate at six months after drug initiation. Predictive factors for resistance to CDAI-LDA achievement for JAK inhibitor treatment included baseline CDAI (odds ratios, 1.09 for tofacitinib and 1.07 for baricitinib), baseline C-reactive protein (CRP; odds ratio, 1.32 for tofacitinib), baseline glucocorticoid dose (odds ratio, 1.18 for baricitinib), and number of previous biological or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs; odds ratio, 1.36 for baricitinib).
“Baseline CRP titer and CDAI were identified as predictive factors for resistance to LDA achievement with TOFA,” the authors write. “Baseline glucocorticoid dose, baseline CDAI, and number of previous b/tsDMARDs were identified as the predictive factors with BARI.”
Several authors disclosed ties to the pharmaceutical industry.
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