Drug retention of biologics and Janus kinase inhibitors in patients with rheumatoid arthritis: the ANSWER cohort study

Objectives This multicentre retrospective study in Japan aimed to assess the retention of biological disease-modifying antirheumatic drugs and Janus kinase inhibitors (JAKi), clarify factors affecting their a real-world cohort patients with rheumatoid arthritis. Methods The included 6666 treatment courses (bDMARD-naïve or JAKi-naïve cases, 55.4%; tumour necrosis factor (TNFi) = 3577; anti-interleukin-6 receptor antibodies (aIL-6R) 1497; cytotoxic T lymphocyte-associated antigen-4-Ig (CTLA4-Ig) 1139; JAKi=453 cases). reasons for discontinuation were divided into four categories (ineffectiveness, toxic adverse events, non-toxic remission); multivariate Cox proportional hazards modelling by potential confounders was used analyse HRs discontinuation. Results TNFi (HR=1.93, 95% CI: 1.69 2.19), CTLA4-Ig (HR=1.42, 1.20 1.67) JAKi (HR=1.29, 1.03 1.63) showed higher rate due ineffectiveness than aIL-6R. (HR=1.28, 1.05 1.56) aIL-6R (HR=1.27, 1.57) events CTLA4-Ig. Concomitant use oral glucocorticoids (GCs) at baseline associated (HR=1.24, 1.09 1.41), as well (HR=2.30, 1.23 4.28) 95%CI: 1.07 1.55). Conclusions (HR=1.52, 1.37 1.68) (HR=1.14, 1.00 1.30) overall drug rate, excluding non-toxicity remission,