Background: In 2017 a new class of oral disease modifying anti-rheumatic drugs (DMARDs), janus kinase inhibitors (JAKi), were licensed for rheumatoid arthritis (RA): baricitinib and tofacitinib. In the UK, they are approved for use in patients with high disease activity with or without methotrexate, following failure of conventional synthetic (cs) DMARDs or biologic DMARDs, the latter when rituximab is contraindicated. As a new therapy option, it is currently unclear how and when these drugs are being prescribed in patients with RA.
Objectives: This analysis aims to describe the characteristics of patients starting JAKi and registered with the BSRBR-RA.
Methods: The BSRBR-RA aims to capture exposure and outcome data in patients with RA receiving biologics, biosimilars and targeted synthetic DMARDs. At the start of therapy, demographic and clinical data, including past treatment data, are collected. Characteristics of all patients receiving a JAKi for the first time with data recorded in the BSRBR-RA up to 30/11/2018 are described.
Results: To 30/11/2018, 443 patients in the BSRBR-RA have been treated with a JAKi; 374 patients baricitinib and 69 tofacitinib (Table). Twenty-eight percent of baricitinib and 13% of tofacitinib patients received a JAKi following csDMARDs, with no prior biologic exposure. Of these, 15% had a prior malignancy history. Of those with prior exposure, the median number of previous biologics was 3 (IQR 2-4) and 52% had received rituximab. Forty-three percent were receiving concurrent methotrexate.
Conclusion: To date, more patients have been recruited starting baricitinib than tofacitinib, likely owing to the later licensing of tofacitinib. Two groups are emerging with a quarter of patients receiving JAKi immediately after csDMARDs and a majority as a later stage alternative following multiple biologics. Further recruitment and follow-up patients will allow for analysis of real-world safety and effectiveness, but differences in patient characteristics will need to be considered in any comparative effectiveness analyses.
Disclosure of Interests: Jennifer Page: None declared, Lianne Kearsley-Fleet: None declared, Rebecca Davies: None declared, Kath Watson: None declared, Kimme Hyrich Grant/research support from: Grants to institution: BMS, Pfizer, UCB, Mark Lunt: None declared
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.