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TOPLINE
Patients with rheumatoid arthritis (RA) who started treatment with certain biologics were less likely to discontinue glucocorticoids (GCs) by 6 months than those who started with JAK inhibitors.
METHODOLOGY
- Researchers conducted a retrospective observational study to assess the discontinuation of GCs after initiating biologic or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in adults with RA.
- They used data from a population-based registry in Hong Kong and identified 2865 patients who were prescribed their first-ever b/tsDMARD between January 2006 and December 2021.
- The final analysis included 1421 patients (49.6%) who were also receiving GC therapy when they started a b/tsDMARD; their median age was 57 years, and 81.8% were women.
- Treatments analyzed included JAK inhibitors, anti-TNF agents, anti-interleukin-6 (anti-IL-6) agents, anti-CD20 agents, and cytotoxic T lymphocyte-associated antigen-4-immunoglobulin (CTLA4-Ig) therapies. Concomitant medications were also assessed.
- Researchers assessed discontinuation of GCs at 3 and 6 months after treatment initiation and adjusted the analyses for relevant confounders.
TAKEAWAY
- The cumulative rate of GC discontinuation was 26.2% at 3 months and 36.8% at 6 months after initiating b/tsDMARDs.
- Patients who started anti-TNF agents had 48.0% lower odds of GC discontinuation at 3 months than those who started JAK inhibitors (P < .001); patients who started anti-CD20 agents had 86.6% lower odds of GC discontinuation (P < .001).
- Starting anti-TNF agents, anti-CD20 agents, or CTLA4-Ig was associated with 44.0%-53.9% lower odds of GC discontinuation at 6 months compared with starting JAK inhibitors (P < .05 for all).
- Prior chronic GC use and hypertension were associated with lower odds of GC discontinuation at both 3 and 6 months (P < .05 for all). The odds did not differ significantly between JAK inhibitors and anti-IL-6 agents at either timepoint.
IN PRACTICE
"[T]he finding from our real-world data that half of the patients (49.6%) started on b/tsDMARDs had concurrent GC use highlights an obvious gap between practice and guidelines. This calls for better education for healthcare professionals and patients," the authors of the study wrote.
SOURCE
The study was led by Yingzhao Jin, The Chinese University of Hong Kong in Shatin, Hong Kong, China. It was published online on September 23, 2026, in Seminars in Arthritis and Rheumatism.
LIMITATIONS
Researchers could not exclude residual confounding because the database lacked consistent data on certain measures. Treatment was not randomly assigned; thus, prescribing may have reflected clinician or patient choice, disease state, or coexisting illnesses. The data came from a registry covering Hong Kong only.
DISCLOSURES
The study did not receive any funding. The authors declared having no competing interests.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
