Are JAKis more effective among elderly patients with RA, smokers and those with higher cardiovascular risk? A comparative effectiveness study of b/tsDMARDs in Sweden.

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Fältnamn	Indikatorer	Metadata
000		07225naa a2200733 4500
001		oai:gup.ub.gu.se/333242
003		SwePub
008		240528s2023 \| \|\|\|\|\|\|\|\|\|\|\|000 \|\|eng\|
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024	7	a https://gup.ub.gu.se/publication/3332422 URI
024	7	a https://doi.org/10.1136/rmdopen-2023-0036482 DOI
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042		9 SwePub
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100	1	a Bower, Hannahu Karolinska Institute,Karolinska Institutet,Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden.4 aut
245	1 0	a Are JAKis more effective among elderly patients with RA, smokers and those with higher cardiovascular risk? A comparative effectiveness study of b/tsDMARDs in Sweden.
264	1	b BMJ Publishing Group Ltd,c 2023
520		a To investigate whether the relative effectiveness of janus kinase inhibitors (JAKis) versus tumour necrosis factor inhibitors (TNFi) or other biological disease-modifying antirheumatic drugs in rheumatoid arthritis differ by the presence or absence of risk factors for cardiovascular (CV) disease, age, sex and smoking.Through Swedish registers, we identified 13493 individuals with 3166 JAKi, 5575 non-TNFi and 11 286 TNFi treatment initiations 2016-2022. All lines of therapy were included, with the majority in second line or higher. Treatment response was defined as the proportion reaching European Alliance of Associations for Rheumatology (EULAR) good response and Clinical Disease Activity Index (CDAI) remission, respectively, within 6 months. Crude percentage point differences in these proportions (JAKis, and non-TNFis, vs TNFis) overall and by risk factors were observed, and adjusted for confounders using linear regression models. Predicted probabilities of response and remission were estimated from adjusted Poisson models, and presented across CV risk and age.Overall, adjusted percentage point differences indicated higher response (+5.0%, 95% CI 2.2% to 7.9%) and remission (+5.8%, 95% CI 3.2% to 8.5%) with JAKis versus TNFis. The adjusted percentage point differences for response in those above 65, at elevated CV risk, and smokers were +5.9% (95% CI 2.7% to 9.0%), +8.3% (95% CI 5.3% to 11.4%) and +6.0% (95% CI 3.3% to 8.7%), respectively. The corresponding estimates for remission were +8.0% (95% CI 5.3% to 10.8%), +5.6% (95% CI 3.0% to 8.2%) and +7.6% (95% CI 5.5% to 9.7%).As used in clinical practice, response and remission at 6 months with JAKis are higher than with TNFi. Among patients with risk factors of concern, effectiveness is similar or numerically further increased. For individualised benefit-to-risk ratios to guide treatment choice, safety and effectiveness in specific patient segments should be considered.
650	7	a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Reumatologi och inflammation0 (SwePub)302102 hsv//swe
650	7	a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Rheumatology and Autoimmunity0 (SwePub)302102 hsv//eng
653		a Humans
653		a Aged
653		a Sweden
653		a epidemiology
653		a Janus Kinase Inhibitors
653		a Smokers
653		a Cardiovascular Diseases
653		a epidemiology
653		a etiology
653		a Risk Factors
653		a Tumor Necrosis Factor-alpha
653		a Tumor Necrosis Factor Inhibitors
653		a Heart Disease Risk Factors
653		a Arthritis
653		a Arthritis, Rheumatoid
653		a Biological Therapy
653		a Epidemiology
700	1	a Frisell, Thomasu Karolinska Institute,Karolinska Institutet,Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden.4 aut
700	1	a di Giuseppe, Danielau Karolinska Institute,Karolinska Institutet,Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden.4 aut
700	1	a Delcoigne, Benedicteu Karolinska Institute,Karolinska Institutet,Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden.4 aut
700	1	a Lindström, Ulfu Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning,Institute of Medicine, Department of Rheumatology and Inflammation Research,Univ Gothenburg, Inst Med, Sahlgrenska Acad, Dept Rheumatol & Inflammat Res, Gothenburg, Sweden.,Sahlgrenska Academy4 aut0 (Swepub:lu)bioo-uli
700	1	a Turesson, Carlu Lund University,Lunds universitet,Reumatologi,Forskargrupper vid Lunds universitet,Rheumatology,Lund University Research Groups4 aut0 (Swepub:lu)med-ctn
700	1	a Chatzidionysiou, Katerinau Karolinska Institutet,Karolinska Univ Hosp, Rheumatol Theme Inflammat & Ageing, Stockholm, Sweden.,Karolinska University Hospital4 aut
700	1	a Lindqvist, Elisabetu Lund University,Lunds universitet,Reumatologi och molekylär skelettbiologi,Sektion III,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Lund Arthritis Research Group (LARG),Forskargrupper vid Lunds universitet,Rheumatology,Section III,Department of Clinical Sciences, Lund,Faculty of Medicine,Lund University Research Groups4 aut0 (Swepub:lu)reum-eli
700	1	a Knight, Annu Uppsala University,Uppsala universitet,Reumatologi4 aut0 (Swepub:uu)ankni172
700	1	a Forsblad d'Elia, Helena,d 1961u Gothenburg University,Göteborgs universitet,Institutionen för medicin,Institutionen för medicin, avdelningen för reumatologi och inflammationsforskning,Institute of Medicine,Institute of Medicine, Department of Rheumatology and Inflammation Research,Univ Gothenburg, Inst Med, Sahlgrenska Acad, Dept Rheumatol & Inflammat Res, Gothenburg, Sweden.,Sahlgrenska Academy4 aut0 (Swepub:gu)xforhe
700	1	a Askling, Johanu Karolinska Institute,Karolinska Institutet,Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden.;Karolinska Univ Hosp, Rheumatol Theme Inflammat & Ageing, Stockholm, Sweden.,Karolinska University Hospital4 aut
710	2	a Karolinska Institutetb Karolinska Inst, Dept Med Solna, Clin Epidemiol Div, Stockholm, Sweden.4 org
773	0	t RMD opend : BMJ Publishing Group Ltdg 9:4q 9:4x 2056-5933
856	4	u https://doi.org/10.1136/rmdopen-2023-003648y Fulltext
856	4	u https://uu.diva-portal.org/smash/get/diva2:1832318/FULLTEXT01.pdfx primaryx Raw objecty fulltext:print
856	4	u http://dx.doi.org/10.1136/rmdopen-2023-003648x freey FULLTEXT
856	4 8	u https://gup.ub.gu.se/publication/333242
856	4 8	u https://doi.org/10.1136/rmdopen-2023-003648
856	4 8	u http://kipublications.ki.se/Default.aspx?queryparsed=id:154665333
856	4 8	u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-521845
856	4 8	u https://lup.lub.lu.se/record/1bef2d41-0240-49ca-b2d8-322ddf8a5416

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By the author/editor: Bower, Hannah; Frisell, Thomas; di Giuseppe, Dan ...; Delcoigne, Bened ...; Lindström, Ulf; Turesson, Carl; show more...; Chatzidionysiou, ...; Lindqvist, Elisa ...; Knight, Ann; Forsblad d'Elia, ...; Askling, Johan; show less...

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MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Rheumatology and ...

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