As use of Janus Kinase inhibitor (JAKi) therapies in rheumatoid arthritis (RA) have increased, so has awareness of cardiovascular (CV) and malignancy safety concerns associated with the class. This study’s goal is to compare gender, comorbidities, and JAKi use in RA patients switched to JAKi therapies in the US and EU5.
In July-September 2020, US (n=200) and EU5 (n=310) rheumatologists contributed patient chart data for biologic/JAK treated RA patients (US (n=1,000); EU5 (n=1,288)). Data has been collected annually in the US since 2016 and EU5, 2017.
US females switched to a JAKi therapy were statistically more likely to have a high CV risk and obesity compared to EU5 females. EU5 males were statistically more likely to have malignancy risk and a history of smoking than US males. Additionally, statistical differences were found between the genders within a region. Tofacitinib use is higher than baricitinib in the US, while the opposite in the EU5. JAK cycling has increased in both regions year over year.
Cardiovascular Risk | Malignancy Risk | Cancer | DVT/PE | High BP | Hyperlipidemia | MI | Obesity | Smoker | None | ||
---|---|---|---|---|---|---|---|---|---|---|---|
EU5 JAK patients | Male (95) | 25.26% | 18.95% | 2.11% | 2.11% | 38.95% | 28.42% | 7.37% | 13.68% | 25.26% | 21.05% |
Female (199) | 9.05% | 11.06% | 1.01% | 0.00% | 23.62% | 10.55% | 0.50% | 9.55% | 9.05% | 35.18% | |
US JAK patients | Male (110) | 25.45% | 8.18% | 1.82% | 1.82% | 41.82% | 30.00% | 4.55% | 20.00% | 6.36% | 26.36% |
Female (196) | 15.82% | 14.80% | 1.53% | 0.00% | 28.06% | 15.82% | 1.02% | 21.94% | 7.14% | 26.53% |
Different considerations between genders and regions should be given when switching RA patients to JAKi therapy in the US and EU5.
Proinflammatory cytokines play critical role in the pathophisology of rheumatoid arthritis (RA). Recent studies concerning IL-8 support its role in ACPA-mediated osteoclast activation as a mechanism of arthralgia and bone loss, but the functional involvement of this cytokine are still uninvestigated. This analysis aimed to determine the association of IL-8 cytokine levels with clinical variables in patients with RA.
63 patients with RA and 25 patients in control group were included in this study. The cytokines levels in serum were evaluated by the ProcartaPlex immunoassays kits (eBioscience, Affymetrix) on the Luminex xMAP system according to manufacturer’s instruction.
IL-8 was elevated in RA patient group (p<0.0001). We found differences between control group and RA activity groups according to Disease Activity Score in 28 joints (Figure1.).
Figure 1. IL-8 concentration in RA and healthy control. Blue line connects medians.
IL-8 was also positively correlated with C-reaction protein (r=0,43), erythrocyte sedimentation rate (r=0,4), level of autoantibodies (RF: r=0,54; ACPA: r=0,51). Furthermore there was correlation between IL-8 and number of swollen (r=0.38) and painfull joints (r=0.33).
Circulating IL-8 is correlated with disease activity and ACPA, therefore may impact the pathogenesis and progression of RA and may be the point of further investigations.