1692: Insights on the Use of JAK-inhibitors in Patients with Psoriatic Arthritis in an International Collaboration of Registers (the “JAK-pot” Study)

Romain Aymon¹, Denis Mongin², Burkhard Leeb³, Monika Mustak-Blagusz⁴, Jakub Závada⁵, Karel Pavelka⁶, Dan Nordstrom⁷, Nina Trokovic⁸, Florenzo Iannone⁹, Catalin Codreanu¹⁰, Ziga Rotar¹¹, Tore Kvien¹², Sella Provan¹³, Manuel Enrique Pombo Suarez¹⁴, Fernando Alonso¹⁵, Fatos Onen¹⁶, Nevsun Inanc¹⁷, Louis Coupal¹⁸, Denis Choquette¹⁹, Galina Lukina²⁰, Ori Elkayam²¹, Victoria Furer²¹, Ana Maria Rodrigues²², Delphine COURVOISIER²³, Axel Finckh²⁴, Michael Nissen² and Kim Lauper²⁵, ¹Geneva University Hospitals, Collonges-sous-Salève, France, ²Geneva University Hospitals, Geneva, Switzerland, ³BioReg, Stockerau, Austria, ⁴BioReg, Vienna, Austria, ⁵Institute of Rheumatology, Prague, Czech Republic, ⁶Institut of Rheumatology and Department of Rheumatology, First Faculty of Medicine, Charles University, Praha, Czech Republic, ⁷Helsinki University Hospital, Helsinki, Finland, ⁸University of Helsinki, Helsinki, Finland, ⁹Rheumatology Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", Bari, Italy, ¹⁰Center for Rheumatic Diseases, Bucharest, Romania, ¹¹University Medical Centre Ljubljana, Ljubljana, Slovenia, ¹²Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway, ¹³Diakonhjemmet Hospital, Oslo, Norway, ¹⁴Hospital Cl­ínico Universitario, Santiago de Compostela, Spain, ¹⁵Spanish Society of Rheumatology, Madrid, Spain, ¹⁶Division of Rheumatology, Dokuz Eylul University School of Medicine, Izmir, Turkey, ¹⁷Division of Rheumatology, Medical School, Marmara University, Istanbul, Turkey, ¹⁸Institut de Rhumatologie de Montréal, Montreal, QC, Canada, ¹⁹Centre hospitalier de l'Université de Montréal (CHUM), Université de Montréal, Montréal, QC, Canada, ²⁰Federal state budgetary scientific institution "V.A. Nasonova Research Institute of Rheumatology", Moscow, Russia, ²¹Tel Aviv Medical Center, Tel Aviv, Israel, ²²Sociedade Portuguesa de Reumatologia; Nova Medical School; Hospital dos Lusíadas, Lisbon, Portugal, ²³Division of Rheumatology, Geneva University Hospitals, Geneva, Switzerland, ²⁴HUG, Geneva, Switzerland, ²⁵Geneva University Hospitals, Genève, Switzerland

Background/Purpose: JAK-inhibitors (JAKi) are increasingly being prescribed to treat various inflammatory conditions, including psoriatic arthritis (PsA). While the understanding of JAKi efficacy and safety in rheumatoid arthritis is progressing, it remains less developed for PsA. The purpose of this study was to evaluate the profile of PsA patients to whom JAKi are prescribed, in a large multi-country real-world collaboration (JAK-pot).

Methods: Patients with a diagnosis of PsA, treated with either JAKi, TNF-inhibitors (TNFi) or bDMARDs with other modes of action (OMA) were included from 10 registers in which JAKi were prescribed for PsA. Treatment-courses were included only since JAKi became available in each country. We used standard descriptive statistics to evaluate patient-, disease-, and treatment characteristics across treatment groups, and across registers for JAKi only. We plotted crude retention rates for each treatment group.

Results: Among the 11,939 treatment courses considered (Table 1), 582 were JAKi, mainly tofacitinib (67%) and upadacitinib (27%), and to a lesser extent baricitinib (6%). Patients initiating JAKi tended to have more difficult to treat disease, defined as longer disease duration ( > 9 years), older age, more prior bDMARD experience (52% with 3 or more previous bDMARDs), and more concomitant glucocorticoids. JAKi patient characteristics were consistent across countries (Table 2), despite varying use of specific JAKi agents, tofacitinib use ranging from 36 to 100% and upadacitinib from 0 to 64%. Crude drug retention at 1 year was 65% for JAKi was (Figure 1), which was significantly lower than for OMA (74%) and TNFi (77%).

Conclusion: Unadjusted drug retention rates for second line therapies in PsA patients suggest lower drug maintenance of JAKi compared to OMA and TNFi. However, it is likely that these results are largely driven by the severity of the disease of patients on JAKi compared to patients on other treatments. Adjusted analyses are needed when evaluating the real-life effectiveness and safety of JAKi for PsA patients.








R. Aymon: None; D. Mongin: None; B. Leeb: AbbVie/Abbott, 2, Biogen, 2, 6, Celgene, 2, 6, Eli Lilly, 2, 6, Pfizer, 2, 6; M. Mustak-Blagusz: None; J. Závada: AbbVie/Abbott, 2, 6, Egis, 2, 6, Eli Lilly, 2, 6, Novartis, 2, 6, Sandoz, 2, 6, UCB, 2, 6; K. Pavelka: Abbvie, 2, 6, Amgen, 2, 6, Bristol-Myers Squibb(BMS), 2, 6, Egis, 2, 6, MSD, 2, 6, Pfizer, 2, 6, Roche, 2, 6, UCB, 2, 6; D. Nordstrom: AbbVie/Abbott, 2, BMS, 2, Lilly, 2, MSD, 2, Novartis, 2, Pfizer, 2, UCB, 2; N. Trokovic: None; F. Iannone: Abbvie, 2, 5, BMS, 2, 5, Janssen, 2, 5, Lilly, 2, 5, MSD, 2, 5, Novartis, 2, 5, Pfizer, 2, 5, Roche, 2, 5, UCB, 2, 5; C. Codreanu: AbbVie/Abbott, 2, 6, Amgen, 1, 6, Boehringer-Ingelheim, 1, 6, Eli Lilly, 1, 6, Novartis, 1, 6, Pfizer, 1, 6; Z. Rotar: None; T. Kvien: AbbVie/Abbott, 1, 2, 6, Bristol-Myers Squibb(BMS), 5, Galapagos, 2, 5, Gilead, 2, grunenthal, 6, Janssen, 2, 6, Novartis, 5, Pfizer, 2, 5, sandoz, 2, 6, UCB, 2, 5, 6; S. Provan: None; M. Pombo Suarez: Janssen, 6, MSD Spain, 6; F. Alonso: None; F. Onen: AbbVie/Abbott, 6, Amgen, 6, Novartis, 6, Pfizer, 6, UCB, 6; N. Inanc: AbbVie/Abbott, 2, 6, Abdi Ibrahim, 2, 6, Amgen, 2, 6, Boehringer-Ingelheim, 2, 6, Eli Lilly, 2, 6, Merck/MSD, 2, 6, Novartis, 2, 6, Pfizer, 2, 6, Roche, 2, 6; L. Coupal: None; D. Choquette: AbbVie, 2, 5, 6, Amgen, 2, 5, 6, Eli Lilly, 2, 5, 6, Fresenius-Kabi, 2, 5, 6, JAMP pharma, 2, 5, 6, Novartis, 2, 5, 6, Pfizer, 2, 5, 6, Sandoz, 2, 5, 6, Tevapharm, 2, 5, 6; G. Lukina: None; O. Elkayam: None; V. Furer: None; A. Rodrigues: AbbVie/Abbott, 5, Amgen, 5, 6, Novartis, 5, Pfizer, 5; D. COURVOISIER: None; A. Finckh: None; M. Nissen: AbbVie/Abbott, 2, Eli Lilly, 2, 12, Involved in Clinical Trial, Janssen, 2, Novartis, 6, 12, research funding paid to institution, Pfizer, 6, UCB, 2, 12, funding support to attend EULAR 2023, paid to institution; K. Lauper: Eli Lilly, 5, Pfizer, 2.