Are There Sex-Related Differences in the Effectiveness of Janus Kinase Inhibitors in Rheumatoid Arthritis Patients?
Martinez-Molina, Cristina (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Feliu, Anna (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Park, Hye S (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Juanes-Borrego, Ana (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Díaz Torne, César (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Vidal, Silvia (Institut de Recerca Sant Pau)
Corominas, Hèctor (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Universitat Autònoma de Barcelona

Fecha:	2024
Resumen:	There is evidence suggesting the existence of sex differences in the effectiveness of specific drug classes for rheumatoid arthritis (RA). Our study stands as the first to elucidate sex-related differences in the effectiveness of Janus kinase (JAK) inhibitors. The study involved 150 RA patients treated with tofacitinib, baricitinib, upadacitinib, or filgotinib between September 2017 and October 2023. Sex differences in achieving remission and low disease activity (LDA) were identified through logistic regression analyses. Sex disparities in treatment effectiveness survival were evaluated through the Kaplan-Meier estimate, employing the log-rank test for comparison. The Cox model was applied to analyze the variable sex as a potential factor that could influence the maintenance of the JAK inhibitor treatment effectiveness. Concerning the achievement of remission and LDA, no differences were observed between sexes in terms of the 28-joint Disease Activity Score (DAS28) C-reactive protein (CRP), the Clinical Disease Activity Index (CDAI), and the Simplified Disease Activity Index (SDAI). With respect to the DAS28-erythrocyte sedimentation rate (ESR), female patients, compared to males, possessed 70% lower odds of achieving remission (p = 0. 018) and 66% lower odds of achieving LDA (p = 0. 023). No differences were observed in treatment effectiveness survival between sexes (p = 0. 703). Sex was not found to influence the survival of JAK inhibitor treatment effectiveness (p = 0. 704). Being a female or male patient does not entail differences in the effectiveness of the JAK inhibitor treatment. Our findings encourage the consideration of a global pool of composite indices (DAS28-ESR/CRP, CDAI, SDAI) to measure RA disease activity, thus individualizing the target value as advocated by the treat-to-target strategy.
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Lengua:	Anglès
Documento:	Article ; recerca ; Versió publicada
Materia:	Baricitinib ; Filgotinib ; Janus kinase inhibitor ; Rheumatoid arthritis ; Sex-related differences ; Tofacitinib ; Treat-to-target ; Treatment effectiveness ; Upadacitinib
Publicado en:	Journal of clinical medicine, Vol. 13 (april 2024) , ISSN 2077-0383

DOI: 10.3390/jcm13082355
PMID: 38673626

9 p, 779.3 KB

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