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AB0442 RETROSPECTIVEANALYSIS ON JAKINHIBITORS AT SINGLECENTRE IN THE UK Deepak NagraKatie BechmanMark Russell2023 год

AB0442 RETROSPECTIVE ANALYSIS ON JAK INHIBITORS AT SINGLE CENTRE IN THE UK
статья

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Аннотация:

Background

There are limited real world data on the use of JAK inhibitors (JAKi). In 2022, the EMA suggested that JAKi should only be used if alternative therapies are not available in patients over 65 years, smokers or in those with cardiovascular or cancer risk factors.

Objectives

We conducted a retrospective study to describe the demographics, duration of therapy and adverse events profile of patients prescribed JAKi.

Methods

Baseline data including age, gender, smoking status, ethnicity, co-morbidities, cardiovascular risk factors, rheumatic diagnosis, concomitant csDMARD use and prior biological therapies was collected. Duration on therapy and reasons for stopping JAKi were identified. A Cox proportional hazard model was used to plot survival of drug therapy, by JAKi drug. Data was analysed on the STATA platform.

Results

In total, 151 patients were prescribed a JAKi since 2017. The average age was 55, with a female predominance, (n=125, 83%), and the majority had rheumatoid arthritis. Baricitinib and Filgotinib represented the most commonly prescribed JAKi. Over ¼ of the cohort were using JAKi monotherapy (28%). For those on combination therapy, methotrexate was the most commonly prescribed (53%). The median number of prior biologics was 1 (IQR 1-2), with TNFi the most frequently prescribed (66%). 48% had cardiovascular risk factors or cardiovascular disease; this was more prevalent in patients prescribed baricitinib or tofacitinib compared to upadacitinib or filgotinib (57%) versus (39%). During JAKi therapy 3 patients developed cancer, 2 had VTEs (both on Baricitinib) and 5 had new mental health diagnoses. The reason for stopping therapy was equally spilt between drug failure (46%) and adverse events (45%). Drug survival over 2 years was numerically higher for Filgotinib and Upadacitinib. Cycling between JAKi occurred in 28 patients. Patients prescribed a second JAKi (n=26) or a third JAKi (n=2) had cycled through more prior biologics than patients prescribed their first JAKi [median number prior biologics 2 (IQR 1-3) versus 1 (IQR 1-2) p=0.007].

Conclusion

Our real world experience of JAKi is broadly similar to expectations from clinical trials. The differences in patient characteristics and drug survival between individual JAKi are likely to reflect drug availability and emergence of safety warnings over time.

REFERENCES:

NIL.

Acknowledgements:

NIL.

Disclosure of Interests

Deepak Nagra Consultant of: Fees from abbvie, Katie Bechman Grant/research support from: Versus Arthritis and NIHR, Mark Russell Speakers bureau: Lilly, Galapagos, Biogen and Menarini, and support. for attending meetings from Lilly, Pfizer, Janssen and UCB, Consultant of: lilly, Edward Alveyn: None declared, christopher baldwin: None declared, georgina bird: None declared, Sophia Steer: None declared, Corrine Byrne: None declared, Kirsty Lawan: None declared, valeria vescovi: None declared, maryam adas Consultant of: Abbvie, Meryem Nursoy: None declared, Sam Norton Speakers bureau: janssen and pfizer, Arti Mahto Speakers bureau: Speaker fees galapagos, abbvie, GE, Andrew Rutherford: None declared, James Galloway Speakers bureau: Abbvie, Biovitrum, BMS, Celgene, Chugai, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi, Sobi and UCB, Consultant of: Abbvie, Biovitrum, BMS, Celgene, Chugai, Galapagos, Gilead, Janssen, Lilly, Novartis, Pfizer, Roche, Sanofi, Sobi and UCB, Elena Nikiphorou Speakers bureau: celltrion, pfizer, sanofi, gillead, galapagos, abbvie, lilly, fresenius, Grant/research support from: pfizer and lilly.
Год издания: 2023
Авторы: Deepak Nagra, Katie Bechman, Mark Russell, Edward Alveyn, Corisande Baldwin, Geoffrey L. Bird, Sophia Steer, Corrine Byrne, K. Lawan, V. Vescovi, Maryam Adas, Mustafa Nursoy, Sam Norton, Arti Mahto, Andrew I Rutherford, James Galloway, Elena Nikiphorou
Ключевые слова: Cytokine Signaling Pathways and Interactions, Myeloproliferative Neoplasms: Diagnosis and Treatment, Acute Lymphoblastic Leukemia research