Deprez Valentine, Le Monnier Laure, Sobhy-Danial Jean-Marc, Grados Franck, Henry-Desailly Isabelle, Salomon-Goëb Sarah, Rabin Thibault, Ristic Sanja, Fumery Mathurin, Fardellone Patrice, Goëb Vincent
Department of Rheumatology, Amiens University Hospital, 80000 Amiens, France.
Department of Gastroenterology, Amiens University Hospital, 80000 Amiens, France.
J Clin Med. 2020 Oct 16;9(10):3319. doi: 10.3390/jcm9103319.
Janus kinase inhibitors (JAKis) represent a new alternative to treat rheumatoid arthritis (RA). The objective of this study was to evaluate the effectiveness, tolerance profile, and maintenance of these treatments (tofacitinib and baricitinib) in real life.
All patients in the rheumatology department of Amiens University Hospital treated by JAKis for RA were included from 1 October 2017 to 20 May 2020. Clinical and biological data were provided retrospectively in this observational and single-center study. We aimed to study the JAKi maintenance rate at 12 months and their clinical and biological safety profiles.
Fifty-five patients were included. Drug maintenance at 12 months was 67.6%. Factors associated with poorer maintenance were a higher Charlson comorbidity index (HR 1.311 (1.089-1.579); = 0.0042), a higher age (HR 1.055 (1.015-1.096); = 0.0067), and corticosteroids therapy at initiation (HR 2.722 (1.006-7.365); = 0.0487). The clinical and biological safety profile was generally good.
Our study found that a higher Charlson index, age, and corticosteroids appeared to be associated with the earlier discontinuation of treatment. JAKis had a response and tolerance profile in real life at least equivalent to that of biological disease-modifying antirheumatic drugs (bDMARDs).
Janus激酶抑制剂(JAKis)是治疗类风湿性关节炎(RA)的一种新选择。本研究的目的是评估这些治疗药物(托法替布和巴瑞替尼)在实际应用中的有效性、耐受性和维持情况。
纳入2017年10月1日至2020年5月20日在亚眠大学医院风湿病科接受JAKis治疗的所有RA患者。在这项观察性单中心研究中,回顾性提供临床和生物学数据。我们旨在研究JAKi在12个月时的维持率及其临床和生物学安全性。
共纳入55例患者。12个月时的药物维持率为67.6%。与维持较差相关的因素包括较高的Charlson合并症指数(HR 1.311(1.089 - 1.579);P = 0.0042)、较高的年龄(HR 1.055(1.015 - 1.096);P = 0.0067)以及起始时使用皮质类固醇治疗(HR 2.722(1.006 - 7.365);P = 0.0487)。临床和生物学安全性总体良好。
我们的研究发现,较高的Charlson指数、年龄和皮质类固醇似乎与治疗的早期停药有关。JAKis在实际应用中的反应和耐受性至少与生物改善病情抗风湿药物(bDMARDs)相当。