The impact of glucocorticoids on the efficacy of JAK inhibitors or non-TNF-targeted biologics in rheumatoid arthritis
Rheumatology 2025 Doi: 10.1093/rheumatology/keaf612 Epub ahead of print
Salvato et al. showed that the combination of GC and b/tsDMARDs did not provide additional clinical benefits after 12 months, suggesting that chronic GC use alongside advanced therapies should be avoided. Authors assessed the impact of chronic oral low-dose GCs on the efficacy and retention rates of JAKi compared to other mechanisms of action (OMA) therapies in a cohort of RA patients with inadequate response to TNFi.
In this cohort of RA patients with inadequate response to TNFi, subsequent treatment with either a JAKi or a bDMARD demonstrated comparable EULAR good response rates at 6, 12, and 24 months. Patients treated with JAKi achieved significantly higher rates of DAS28-CRP remission at all assessed time points compared to those treated with OMA, independently of GCs use. Exposure to GC at 6 months predicted poorer 24-month outcomes; whilst the proportion of patients who met Boolean remission criteria was low overall and consistent between groups.
