Effects of concomitant methotrexate and predictors of remission in Janus kinase inhibitor therapy for rheumatoid arthritis - 08/01/26
, Kenya Terabe a, Junya Hasegawa a, Yutaka Yoshioka b, Takefumi Kato c, Toshihisa Kojima d, Yusuke Ohno a, Tomonori Kobayakawa e, Tatsuo Watanabe f, Yasumori Sobue g, Tsuyoshi Nishiume h, Mihoko Kato i, Takayoshi Fujibayashi j, Yuji Hirano k, Yasuhide Kanayama l, Toki Takemoto m, Tsuyoshi Watanabe n, Masahiro Hanabayashi o, Hiroyuki Matsubara p, Mochihito Suzuki a, Ryo Sato a, Takaya Sugiura a, Nobunori Takahashi q, Shiro Imagama aHighlights |
• | Concomitant MTX did not predict remission at 24 weeks with JAK inhibitors in RA. |
• | Concomitant MTX may enhance early disease control (i.e., at 12 weeks). |
• | Concomitant MTX effective for patients with moderate to high disease activity. |
• | Radiographic damage, prior b/tsDMARDs, glucocorticoids, high CDAI predicted failure. |
Abstract |
Objective |
To evaluate the effects of concomitant methotrexate (MTX) and predictors of remission in rheumatoid arthritis (RA) patients treated with Janus kinase (JAK) inhibitors.
Methods |
This retrospective study included 681 treatment courses in 569 patients treated with JAK inhibitors. The impact of baseline variables on achieving Clinical Disease Activity Index (CDAI) remission at 24 weeks was assessed using multivariate logistic regression analysis. Disease activity was compared between groups with and without concomitant MTX use [MTX (±)] after inverse probability of treatment weighting adjustment.
Results |
The estimated mean CDAI score was 17.6 at baseline and significantly decreased after 4 weeks. Proportions of patients who achieved CDAI remission were 5% at baseline, 22% at 4 weeks, 31% at 12 weeks, and 36% at 24 weeks. Multivariate analysis revealed that radiographic damage (OR: 0.48, 95% CI: 0.30–0.77), prior biological/targeted synthetic disease-modifying antirheumatic drug use (OR: 0.57, 95% CI: 0.36–0.90), glucocorticoid use (OR: 0.65, 95% CI: 0.43–0.98), and baseline CDAI score (OR: 0.96 per 1 point, 95% CI: 0.94–0.98) independently predicted CDAI remission at 24 weeks. Compared to the MTX (−) group, the MTX (+) group exhibited a significantly higher proportion of patients achieving CDAI remission at 12 weeks, whereas no significant difference was observed at 24 weeks. Subgroup analyses revealed that this difference was evident among patients with moderate to high disease activity.
Conclusion |
Concomitant MTX provided potential advantages in terms of early disease control in JAK inhibitor therapy for RA, particularly in patients with active disease.
Le texte complet de cet article est disponible en PDF.Keywords : Janus kinase inhibitor, Methotrexate, Registry, Remission, Rheumatoid arthritis
Plan
Vol 93 - N° 1
Article 105961- janvier 2026 Retour au numéro
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