SAFETY PROFILE OF JAK INHIBITORS VERSUS TNF INHIBITORS IN REAL-WORLD CLINICAL PRACTICE: DATA FROM A MULTICENTER REGISTER
Authors: B. Hernández-Cruz et al.
Registries are important to get a more comprehensive view of the safety of new compounds in daily practice patients, who tend to be older and have more comorbidities than patients who participate in clinical trials. The Spanish BIOBADASER registry includes patients with rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis. Data of patients enrolled until November 2020 with either a JAK inhibitor or a TNF blocker were included. A total of 5306 patients on anti-TNF and 493 patients on JAK inhibitors were analysed. Patients on JAK inhibitors were older and had a longer disease duration (mean 10 years). First line JAK inhibitors were prescribed in only 24% of patients. Drug survival during the first year was similar for TNF and JAK inhibitors. The main reason for treatment interruption was lack of efficacy (53–59%) and adverse events (25–34%). Serious infections were more frequently observed with JAK inhibitors (IRR 33.2 /1000 PY) compared to TNF inhibitors (IRR 14.2/1000 PY).
This registry data demonstrates that in the majority of patients JAK inhibitors are used second line. This may have various reasons, including the availability of biosimilars (that favour their use in first line), guidelines by authorities on the choice of drugs as well as physicians’ preference. The higher incidence of serious infections and herpes zoster with JAK inhibitors may as well correspond to the older age and longer disease duration of patients on JAKi but physicians need to be aware of it. More real life data is needed to better characterize the risk profile of JAK inhibitors in daily practice patients.