Efficacy of JAK Inhibitors versus DMARDs in the Treatment of Polymyalgia Rheumatica in China

Abstract

Objective

This retrospective analysis was to assess the role of Janus kinases (JAK) inhibitors compared with conventional disease modifying anti-rheumatic drugs (DMRADs) in the treatment of polymyalgia rheumatica (PMR) with glucocorticoids (GCs) reduction.

Methods

Clinical information was collected from PMR patients in the JAK inhibitor group and the DMARDs group from January 2020 to August 2021 at Jiaxing first Hospital. Serum C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), hemoglobin (Hb), albumin and dose of GCs before and after treatment were compared between two groups.

Results

Thirty female patients with PMR were included into this study. The dose of GCs in the JAK inhibitor group was significantly lower than in the DMARDs group at baseline and at 3 and 6 months after treatment. There were no significant differences in various laboratory parameters (including CRP, ESR, Hb and albumin) between two groups (P > 0.05) except that Hb in the DMARDs group was significantly higher than in the JAK inhibitor group at 3 and 6 months after treatment (P<0.05). One patient in the JAK inhibitor group developed herpes zoster, and received tofacitinib treatment after herpes zoster was relieved.

Conclusion

Our study indicates that JAK inhibitors in the treatment of PMR are as effective as DMRADs and are also helpful for the reduction of GCs dose.

Keywords:

• JAK inhibitors
• polymyalgia rheumatica
• glucocorticoids
• disease modifying anti-rheumatic drug

Data Sharing Statement

The datasets generated for this study are available on request to the corresponding author Hongzhi Wang.

Ethical Statement

The authors are accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. The study was conducted in accordance with the Declaration of Helsinki (as revised in 2013). The study was conducted in accordance with the Declaration of Helsinki and approved by the Institutional Review Board of Jiaxing first Hospital (LS2022-KY-013). This is a retrospective analysis, and the data are anonymous, so the informed consent was waived in this study and patient data confidentiality was kept.

Disclosure

The authors declare that they have no competing interests in this work.

Additional information

Funding

This work was supported by the Natural Science Foundation of Zhejiang (No. LQ19H010001) and 2023 Jiaxing Key Discipline of Medicine, Rheumatology and Autoimmunology (Supporting Subject) (No. 2023-ZC-016).