HealthDay News — People with difficult-to-treat rheumatoid arthritis (RA) that does not respond to one Janus kinase inhibitor (JAKi) may achieve a similar response by either cycling to other JAKi medications or switching to a biologic drug, according to a study presented at the annual meeting of the American College of Rheumatology, held virtually from Nov. 3 to 9.
Manuel Pombo-Suarez, M.D., Ph.D., from Hospital Clinico Universitario of Santiago de Compostela in Spain, and colleagues compared the effectiveness of cycling JAKi versus switching to a biologic disease-modifying antirheumatic drug (bDMARD) in a real-world population of RA patients using data from 14 national registries participating in the JAK-pot collaboration. Analysis included 708 patients who failed JAKi (154 cycled to a second JAKi and 554 switched to a bDMARD).
The researchers found that patients cycling JAKi were older, had longer disease duration, had received more bDMARDs, and had longer exposure to first JAKi treatment versus those switching to a bDMARD. Discontinuation of the first JAKi was more often for safety reasons than for lack of effectiveness. At two years of follow-up, cycling and switching strategies showed similar drug survival rates. The Disease Activity Score 28 was similar between patients cycling JAKi and switching to a bDMARD, with improvements seen after one year of follow-up.
“After failing a first JAKi, cycling JAKi versus switching to a bDMARD appears to have similar effectiveness despite a more difficult to treat patient profile for the patients cycling to JAKi,” the authors write.
Several authors disclosed financial ties to the pharmaceutical industry.