A new study published in the journal Rheumatology reveals that JAK inhibitors, commonly used to treat arthritis patients, are indeed effective. Despite initial concerns about their effectiveness, this multicenter, retrospective study conducted by Japanese researchers has shown impressive remission rates in patients, with most opting to continue the treatment
Understanding Rheumatoid Arthritis and Current Treatments
Rheumatoid arthritis is a common autoimmune disease characterized by chronic inflammation of joint linings and results in progressive joint destruction and other systemic complications. The use of biological disease-modifying drugs enables patients to enjoy the achievement of low disease activity and remission. But clinics must administer such drugs through subcutaneous or intravenous routes, which is unpleasant for patients, and over time these drugs commonly become less effective.
Recently scientists have developed Janus kinase (JAK) inhibitors for arthritis treatment. Patients take such drugs orally. Previous research has demonstrated the efficacy and safety of JAK inhibitors in randomized controlled trials.
However, some researchers have questioned the potential efficacy of JAK inhibitors for widespread patient use. In practice, doctors mostly treat patients with JAK inhibitors precisely because those patients have other health problems and so conventional drugs like methotrexate are less effective on them. Real-world patients have distinctive characteristics compared with the patients recruited in randomized controlled trials.
The Japanese Study on JAK Inhibitors
In the present multicenter, retrospective study, researchers using data from 622 patients treated at seven major university hospitals in Japan compared the efficacy and safety of four common JAK inhibitors: tofacitinib, baricitinib, peficitinib, and upadacitinib.
The researchers here found that approximately one in three patients reached remission, three in four reached at least low disease activity, with both numbers representing impressive efficacy. They noted that more than 80% of the patients were still on the JAK inhibitor drugs after six months.
They believe that this is particularly relevant given that immunological secondary treatment failure, where drugs cease to be effective because they produce adverse immune system responses in patients, cannot occur with these oral medications. Immunological secondary treatment failure is common in patients who treat their arthritis with drugs like methotrexate.
Reference: “Real-world comparative study of the efficacy of Janus kinase inhibitors in patients with rheumatoid arthritis: the ANSWER cohort study” by Shinya Hayashi, Shotaro Tachibana, Toshihisa Maeda, Mai Yamashita, Iku Shirasugi, Yuzuru Yamamoto, Hirotaka Yamada, Takaichi Okano, Keisuke Nishimura, Yo Ueda, Sadao Jinnno, Jun Saegusa, Wataru Yamamoto, Koichi Murata, Takayuki Fujii, Kenichiro Hata, Ayaka Yoshikawa, Kosuke Ebina, Yuki Etani, Naofumi Yoshida, Hideki Amuro, Motomu Hashimoto, Ryota Hara, Masaki Katayama, Tadashi Okano and Ryosuke Kuroda, 1 November 2023, Rheumatology.
DOI: 10.1093/rheumatology/kead543
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