Evidence map›Paper›PMID 38151264›Full record

ArticleRMD open2023

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.

Hannah Bower, Thomas Frisell, Daniela di Giuseppe, Benedicte Delcoigne, Ulf Lindström, Carl Turesson, Katerina Chatzidionysiou, Elisabet Lindqvist, Ann Knight, Helena Forsblad-d'Elia and 1 more

Open access · goldAbstract read
In one paragraph

Article in RMD open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.5field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Observational
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 5 institutions in 1 country.

Hannah BowerClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden hannah.bower@ki.se.ORCID 0000-0002-2046-3833
Thomas FrisellClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-5735-9626
Daniela di GiuseppeClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0003-3817-8288
Benedicte DelcoigneClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0002-2716-5679
Ulf LindströmDepartment of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.ORCID 0000-0002-2250-9348
Carl TuressonRheumatology, Department of Clinical Science Malmö, Lund University, Skåne University Hospital, Malmö, Sweden.ORCID 0000-0002-3805-2290
Katerina ChatzidionysiouRheumatology, Theme Inflammation and Ageing, Karolinska University Hospital, Stockholm, Sweden.ORCID 0000-0002-2669-1247
Elisabet LindqvistSection of Rheumatology, Department of Clinical Sciences Lund, Lund University, Skåne University Hospital, Lund, Sweden.ORCID 0000-0002-9937-6352
Ann KnightRheumatology, Department of Medical Sciences, Uppsala University, Uppsala, Sweden.
Helena Forsblad-d'EliaDepartment of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.ORCID 0000-0001-7871-5303
Johan AsklingClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet, Stockholm, Sweden.ORCID 0000-0003-0433-0616
Karolinska Institutet · SEKarolinska University Hospital · SELund University · SEUniversity of Gothenburg · SEUppsala University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo 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.

methodsThrough Swedish registers, we identified 13 493 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.

resultsOverall, 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%).

conclusionsAs 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.

Indexed as

Cardiovascular DiseasesJanus Kinase InhibitorsAgedHeart Disease Risk FactorsHumansRisk FactorsSmokersSwedenTumor Necrosis Factor-alphaTumor Necrosis Factor InhibitorsJanus Kinase InhibitorsTumor Necrosis Factor-alphaTumor Necrosis Factor InhibitorsArthritis, RheumatoidBiological TherapyEpidemiologyTumor Necrosis Factor Inhibitors

Identifiers

PMID38151264
PMCPMC10753711
OpenAlexW4390276755

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.