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KMID : 0338420230380040546
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The Korean Journal of Internal Medicine
2023 Volume.38 No. 4 p.546 ~ p.556
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Comparative effectiveness of JAK inhibitors and biologic disease-modifying antirheumatic drugs in patients with rheumatoid arthritis
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Cho Soo-Kyung
Kim Hyoung-Young
Song Yeo-Jin
Nam Eun-Woo
Lee Shin-Seok
Lee Hye-Soon
Park Sung-Hoon
Lee Yeon-Ah
Park Min-Chan
Chang Sung-Hae
Kim Hyoun-Ah
Kwok Seung-Ki
Kim Hae-Rim
Kim Hyun-Sook
Yoon Bo-Young
Uhm Wan-Sik
Kim Yong-Gil
Kim Jae-Hoon
Lee Ji-Soo
Choi Jeong-Im
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Abstract
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Background/Aims: We aimed to compare the effectiveness and safety of Janus kinase inhibitors (JAKi) vs. biologic disease-modifying antirheumatic drugs (bDMARD) in Korean patients with rheumatoid arthritis (RA) who had an inadequate response to conventional synthetic DMARDs.
Methods: A quasi-experimental, multi-center, prospective, non-randomized study was conducted to compare response rates between JAKi and bDMARDs in patients with RA naive to targeted therapy. An interim analysis was performed to estimate the proportion of patients achieving low disease activity (LDA) based on disease activity score (DAS)?28? erythroid sedimentation rate (ESR) (DAS28-ESR) at 24 weeks after treatment initiation and to evaluate the development of adverse events (AEs).
Results: Among 506 patients enrolled from 17 institutions between April 2020 and August 2022, 346 (196 JAKi group and 150 bDMARD group) were included in the analysis. After 24 weeks of treatment, 49.0% of JAKi users and 48.7% of bDMARD users achieved LDA (p = 0.954). DAS28-ESR remission rates were also comparable between JAKi and bDMARD users (30.1% and 31.3%, respectively; p = 0.806). The frequency of AEs reported in the JAKi group was numerically higher than that in the bDMARDs group, but the frequencies of serious and severe AEs were comparable between the groups.
Conclusions: Our interim findings reveal JAKi have comparable effectiveness and safety to bDMARDs at 24 weeks after treatment initiation.
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KEYWORD
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Janus kinase inhibitor, Tumor necrosis factor inhibitors, Comparative effectiveness research, Safety, Rheumatoid arthritis
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