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TOPLINE
Patients with rheumatoid arthritis (RA) treated with JAK inhibitors had significantly reduced disease activity and improved patient-reported outcomes over 12 months, with no significant differences in effectiveness or safety observed by type 2 diabetes (T2D) status, cardiometabolic multimorbidity, or age.
METHODOLOGY
- Researchers conducted a chart-based observational study across nine tertiary rheumatology centres in Italy between 2020 and 2022 to evaluate the real-world effectiveness and safety of JAK inhibitors in patients with RA.
- They included 440 adults with RA (mean age, 61.0 years; 82.9% women) who had moderate-to-high disease activity at treatment initiation and received JAK inhibitors (tofacitinib, baricitinib, upadacitinib, or filgotinib).
- The main outcome was the 12-month change in the Disease Activity Score in 28 joints calculated with C-reactive protein (DAS28-CRP). Other outcomes included changes in the Simplified Disease Activity Index (SDAI) score, patient-reported outcomes, and safety outcomes.
- Patients were stratified by the presence of T2D, cardiometabolic multimorbidity (defined as having at least two of hypertension, T2D, or dyslipidaemia), and age.
TAKEAWAY
- JAK inhibitor treatment was associated with significant reductions in disease activity over 12 months, with a mean DAS28-CRP decreasing from 3.9 at baseline to 2.4 at month 12 and a mean SDAI score decreasing from 19.8 to 8.1 (P < .0001 for both).
- Significant improvements were observed in patient-reported outcomes, including pain, fatigue, and patient global assessment, alongside reductions in tender and swollen joint counts (P < .001 for all). The proportion of patients receiving glucocorticoids decreased from 60.4% at baseline to 36.4% at 12 months (P < .0001).
- Treatment effectiveness and safety appeared similar between patients with and without T2D, those with and without cardiometabolic multimorbidity, and those aged 65 years or older and those younger than 65 years.
- Adverse events occurred in 18.9% of patients and were mostly mild to moderate and reversible; 7.7% discontinued treatment owing to adverse events. No deaths, serious infections, life-threatening adverse events, or deep vein thrombosis events were reported; one myocardial infarction and one leiomyosarcoma were reported during follow-up.
IN PRACTICE
"In our 'real-life' multicenter cohort in patients with RA, JAKis [JAK inhibitors] demonstrated effectiveness with an acceptable safety profile despite the relatively short follow-up," the authors of the study wrote.
SOURCE
The study was led by Daniela Iacono, University of Campania "Luigi Vanvitelli," Naples, Italy. It was published online on September 02, 2026, in Clinical Rheumatology.
LIMITATIONS
The study was observational, lacked a control group, and had a relatively short follow-up duration, which may have limited the generalisability of the findings. Recruitment from tertiary referral centres may have introduced referral bias. JAK inhibitor treatment was based on routine clinical practice and judgement of physicians, and prescribing patterns may have varied across centres.
DISCLOSURES
This study did not receive any specific funding. The authors declared having no conflicts of interest.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
