Evidence map›Paper›PMID 38748995›Full record

ArticleRheumatology (Oxford, England)2025

Potential impact of European Medicines Agency measures to minimize risk of serious side effects on JAKi prescribing and utilization in the UK.

Zixing Tian, Lianne Kearsley-Fleet, James Galloway, Kath Watson, BSRBR-RA Contributors Group, Mark Lunt, Kimme L Hyrich

Abstract read
In one paragraph

Article in Rheumatology (Oxford, England), 2025. 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
–field-weighted citation impact
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.

  1. Article
  2. Review
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

7 authors.

Zixing TianCentre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.ORCID 0000-0001-9186-1743
Lianne Kearsley-FleetCentre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
James GallowayCentre for Rheumatic Diseases, King's College London, London, UK.ORCID 0000-0002-1230-2781
Kath WatsonCentre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
BSRBR-RA Contributors Group
Mark LuntCentre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.
Kimme L HyrichCentre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology Medicine and Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK.ORCID 0000-0001-8242-9262

Funding

British Society for RheumatologyBSR Biologics RegisterDepartment of Health and Social CareManchester Biomedical Research Centre NIHR203308National Institute for Health and Care ResearchNIHR NIHR203308
6 · The paper itself

Abstract

objectiveJanus kinase inhibitors (JAKis) or targeted synthetic (ts) disease-modifying antirheumatic drugs (DMARDs) effectively treat rheumatoid arthritis (RA). However, due to safety concerns, the European Medicines Agency (EMA) published risk-minimization measures limiting JAKi prescription to certain at-risk patients unless no suitable alternative is available. This analysis included patients who had started their first-ever JAKi (before EMA measures were published) in a large national cohort study to investigate the potential impact of these measures on JAKi prescribing and utilization in the UK.

methodRA patients starting first-ever JAKi therapy in BSRBR-RA between 13 February 2017 and 31 May 2022 were included. The percentages of patients meeting the EMA risk criteria were presented. For the at-risk patients, their previous numbers of distinct biologic (b) DMARD classes prescribed were described.

resultA total of 1341 patients were included, and 80% (N = 1075) met ≥1 EMA risk criterion. Of those who met ≥1 risk criterion, 529 patients (49%) had received JAKi as their first or second b/tsDMARD class, whereas 299 (28%) had received ≥3 prior bDMARD classes.

conclusionFour-fifths of RA patients who had commenced a JAKi before the EMA advisory were considered 'at-risk', with prescribing only advised if there was no suitable alternative. Almost a third of those patients had already received ≥3 bDMARDs classes, and alternative therapies would be very limited for them; however, suitable alternatives might have existed for the remaining proportion, especially for those who received a JAKi as their first or second b/tsDMARD, and re-evaluation of the suitability of their treatment may be needed.

Indexed as

Antirheumatic AgentsArthritis, RheumatoidJanus Kinase InhibitorsPractice Patterns, Physicians'AdultAgedFemaleHumansMaleMiddle AgedUnited KingdomAntirheumatic AgentsJanus Kinase InhibitorsJAK inhibitorreal-world evidencerheumatoid arthritis

Identifiers

PMID38748995
PMCPMC11879295

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Registered trials

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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.