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4CPS-057 Effectiveness, safety, and patient-reported outcome of Janus kinase inhibitors in rheumatoid arthritis in clinical practice
  1. M Iglesias Rodrigo,
  2. N Meca Casasnovas,
  3. J Pardo Pastor,
  4. F Salazar Gonzalez,
  5. B Tenas Rius,
  6. I Vázquez Majó,
  7. C Sebastián Carrasco,
  8. J Nicolás Picó
  1. Pharmaceutic, Hospitalary Pharmacy, Terrassa, Spain


Background and Importance Janus kinase inhibitors (iJAK) are emerging as an effective alternative in the treatment of rheumatoid arthritis (AR), with a manageable toxicity profile. Currently, there is a growing emphasis on achieving comprehensive remission that includes patient-reported outcomes (PROs).

Aim and Objectives Assess the effectiveness and safety of iJAK treatment in clinical AR practice.

Analyze the results obtained from specific PROs to AR.

Material and Methods Retrospective descriptive study including patients with AR treated with iJAKs between Febraury 2018-June 2023. Data collected from electronic medical records: sex, age, iJAK treatment, drug persistence, concomitant disease-modifying antirheumatic drugs (DMARDs), treatment regimen, current effectiveness parameters (Disease Activity Score on 28joint counts [DAS28], and Clinical Disease Activity Index [CDAI]), specific PROs (Rheumathoid Arthritis Impact of Disease [RAID] and Routine Assessment of Patient Index Data [RAPID3]), and adverse effects (AE).

Results 34 patients included. Mean age: 58,12 years (SD: 8,21). 91,18% women. 52,94% of patients undergoing treatment with baricitinib, 20,59% upadacitinib, 14,71% filgotinib, 11,76% tofacitinib. Average drug persistence: 26,84 months (SD: 20,00). 32,35% of patients receiving concomitant treatment with DMARDs. Treatment regimen: 35,30% of patients in first-line treatment, 32,35% second/third-line, 32,35% fourth-line/higher. According to DAS28, 44,12% of patients were in remission (DAS28: 2,16; CDAI: 3,21; RAID: 1,62; RAPID3: 4,15), 32,35% low disease activity (DAS28: 2,99; CDAI: 8,09; RAID: 4,24; RAPID3: 10,38), 17,65% moderate activity (DAS28: 3,97; CDAI: 13,42; RAID: 3,93; RAPID3: 11,80), and 5,88% high activity (DAS28: 5,66; CDAI: 20,50; RAID: 5,35; RAPID3: 14,80). 23.52% of patients experienced AE: 8,82% gastrointestinal, 5,88% cardiovascular, 2,94% infectious, 2,94% metabolic disorder, 2,94% headache.

Conclusion and Relevance Nearly half of patients receiving iJAK treatment are in clinical remission, and almost 75% demonstrate favourable outcomes in activity parameters (remission/low activity). Therefore, iJAKs may represent a promising treatment alternative in AR. Parameters of effectiveness align with PROs results. Regarding safety, iJAKs exhibit a manageable and expected safety profile.

Inclusion of PROs in the concept of comprehensive remission in AR provides a more complete perspective of the patient‘s condition. This enables guiding future interventions, such as prioritising patients with poorer AR control or implementing strategies to optimise healthcare management.

The role of the pharmacist is crucial in ensuring treatment efficacy, adherence, and early detection of toxicities.

Conflict of Interest No conflict of interest.

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