Background and Importance JAK-inhibitors (JAKi) represent an effective choice for patients diagnosed with rheumatoid arthritis (RA). There is limited data available on real use of JAKi.

Aim and Objectives To compare persistence of JAKi, TNF-α inhibitor(TNFi) and non-TNF-α inhibitor(non-TNFi) drugs in patients with RA and reasons for treatment discontinuation.

Material and Methods An ambispective, observational study conducted at a tertiary hospital. Patients diagnosed with RA evaluated at the Rheumatology Interdisciplinary Committee of Biological Drugs from 1 January 2018 to 7 January 2022 that started or switched treatment with JAKi, TNFi and non-TNFi were included. Treatments previously received were included. Follow-up was carried out until 7 January 2023.

Variables collected were age, sex, type of drug, prior biologics (naïve, second-line and third- or higher line), patient’s chronicity level according to the Chronicity Strategy of Valencian Community (0 =healthy individual to 4 = chronic patient of high complexity), length of treatment and reasons for discontinuation.

Outcome variable was percentage of treatments that reached 12 months persistence estimated from the first to the last drug dispensation.

Data were collected from the electronic health and pharmacy dispensing records.

Continuous variables were expressed as mean (SD), and categorical variables as absolute and relative frequency. Chi-square test and logistic regression were used to identify variables associated with persistence. Statistical significance was set at p<0.05. Analysis was carried out with R-4.3.1.

Results There were a total of 303 patients (75% women), mean age was 53 (16) years. We recorded 623 treatments: JAKi 156 (25.0%), TNFi 326 (52.4%) and non-TNFi 156 (22.6%).

Chronicity level (n=177 (58.4%) patients) was: ‘0’ 40 (11.7%), ‘1’ 143 (41.7%), ‘2’ 109 (31.8%), ‘3’ 51 (14.8%). Treatment line: first 284 (45.6%), second 146 (23.4%) and third or higher 193 (31.0%).

No difference in persistence was found among JAKi 108 (69.2%), TNFi 215 (66%) and non-TNFi 80 (56.7%) treatments (p=0.06). Treatment line showed persistence differences: naïve 213 (75%), second-line 81 (55.5%) and third -or higher 109 (56.5%) (p<0.01). No difference was found in persistence according to sex, age or chronicity level. Multivariate analysis confirmed these results.

At the end of follow-up 460 (73.8%) treatments had finished due to: 199 (43.3%) secondary failures; 100 (21.7%) adverse effects; 74 (16.1%) primary failures and others 50 (18.9%). No differences were found among according to type of therapy (p=0,48).

Conclusion and Relevance In our hospital 12-months’ persistence and reasons for discontinuation among JAKi, TNFi and non-TNFi in patients with RA showed no difference.

Conflict of Interest No conflict of interest.