Janus kinase inhibitors (JAKis) and antitumor necrosis factor (TNFi) agents provided quicker improvements in disease activity, function, and pain relief than interleukin-6 (IL-6) inhibitors and abatacept (ABA) for patients with rheumatoid arthritis (RA), according to a study presented at the American College of Rheumatology Convergence.

Researchers compared the short-term effectiveness of JAKis with the other targeted therapies for rheumatoid arthritis (RA) in a real-world international setting (JAK-POT collaboration). The objective was to evaluate the 3-month efficacy of these therapies on disease activity, function, and pain among RA patients.

Data were collected from 14 registers, including 9590 RA patients initiating treatment with either JAKi (n=3049), TNFi (n=4606), IL-6i (n=1284), or ABA (n=651). Survival analysis was used to assess treatment discontinuation, while effectiveness was measured through CDAI, HAQ, and pain trajectories, with adjustments for age, gender, seropositivity, disease duration, previous b/tsDMARD use, and concurrent csDMARD or glucocorticoid therapy.

Patients on TNFi were younger and had shorter disease durations, while those on ABA were generally older and presented with lower disease activity. JAKi patients had the longest disease durations. Discontinuation rates were low (<10% by 6 months), enabling an analysis of disease activity trajectories.

Results indicated that CDAI scores improved rapidly within the first 2 months for JAKi and TNFi, which both showed faster effectiveness than IL-6i and ABA (p<0.001). Functional outcomes (HAQ) and pain scores also improved rapidly for JAKi and TNFi, with ABA showing the slowest improvement. Adjusted analysis confirmed that JAKi and TNFi were associated with a faster reduction in disease activity, function, and pain compared to other therapies.

Reference
Lauper K. How fast do JAK-inhibitors, TNF-inhibitors, abatacept and Il-6 inhibitors act in rheumatoid arthritis? An international collaboration of registers of rheumatoid arthritis patients (the "JAK-POT" study). Presented at: American College of Rheumatology. November 14-19, 2024; Washington, DC.

Reference
Lauper K. How fast do jak-inhibitors, tnf-inhibitors, abatacept and il-6 inhibitors act in rheumatoid arthritis? An international collaboration of registers of rheumatoid arthritis patients (the "JAKPOT" study). Presented at: American College of Rheumatology. November 14-19, 2024; Washington, DC.