| Title: |
Add-on effectiveness of methotrexate or iguratimod in patients with rheumatoid arthritis exhibiting an inadequate response to Janus kinase inhibitors: The ANSWER cohort study. |
| Authors: |
Ebina, Kosuke, Hirano, Toru, Maeda, Yuichi, Okita, Yasutaka, Etani, Yuki, Hirao, Makoto, Yamamoto, Wataru, Hashimoto, Motomu, Murata, Koichi, Onishi, Akira, Jinno, Sadao, Hara, Ryota, Son, Yonsu, Amuro, Hideki, Kotani, Takuya, Shiba, Hideyuki, Katayama, Masaki, Yamamoto, Keiichi, Kumanogoh, Atsushi, Okada, Seiji |
| Source: |
Modern Rheumatology; Jul2023, Vol. 33 Issue 4, p690-699, 10p |
| Subject Terms: |
RHEUMATOID arthritis, ABATACEPT, KINASE inhibitors, METHOTREXATE, COHORT analysis |
| Abstract: |
Objectives: This multicenter, retrospective study evaluated the effectiveness of add-on methotrexate (MTX) or iguratimod (IGU) in patients with rheumatoid arthritis exhibiting an inadequate response to Janus kinase inhibitors (JAKis). Methods: Forty-five patients were treated with new additional MTX (n =22) or IGU (n =23) and followed for 6 months. Patients' background is as follows: age, 59.2 years; disease activity score of 28 joints with C-reactive protein (DAS28-CRP), 3.4; clinical disease activity index, 15.7; biological disease-modifying antirheumatic drug (DMARD)-switched cases, 77.8%; first JAKi cases, 95.6%; and JAKi treatment: tofacitinib (n =25), baricitinib (n =17), upadacitinib (n =2), and peficitinib (n =1) for 9.6 months. Results: Thirty-five patients continued the combination therapy for 6 months without a significant change in concomitant glucocorticoid or other conventional synthetic DMARDs. DAS28-CRP (MTX, 3.6 to 2.6, p < 0.05; IGU, 3.3 to 2.1, p < 0.001) and clinical disease activity index (MTX, 16.7 to 8.8, p < 0.05; IGU, 14.6 to 6.5, p < 0.01) improved significantly from baseline. Using the 2019 European League Against Rheumatism criteria, 45.4% (MTX) and 39.1% (IGU) achieved moderate or good response and 40.9% (MTX) and 39.1% (IGU) achieved American College of Rheumatology 20% improvement criteria. Conclusions: Adding MTX or IGU to inadequate responders of JAKi can be considered as a complementary treatment. [ABSTRACT FROM AUTHOR] |
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| Database: |
Complementary Index |
