Rheumatology · 3 h ago
JAK inhibitor retention similar by age in rheumatoid arthritis cohort
A single-center real-world cohort study compared JAK inhibitor treatment in 317 patients with rheumatoid arthritis aged 65 years or older versus younger patients. Overall drug retention did not differ significantly, but adverse event–related discontinuation accounted for a larger share of discontinuations in the older group, which also had higher herpes zoster incidence.
- Overall JAK inhibitor retention did not differ significantly by age.
- Adverse effects accounted for more discontinuations in older patients.
- Herpes zoster incidence was higher in the older group.
- The study cannot establish cardiovascular or malignancy safety.
Researchers compared JAK inhibitor retention and reasons for stopping treatment among 317 patients with rheumatoid arthritis treated at one tertiary center between 2000 and 2025. The cohort included 97 patients aged 65 years or older and 220 younger patients. Retention was assessed using Kaplan–Meier analysis, and discontinuation factors using multivariable Cox regression. Only one primary reason for discontinuation was recorded per patient.
Overall retention did not differ significantly between age groups (HR 1.18, 95% CI 0.419–1.714; log-rank p=0.680). Among patients who discontinued treatment, adverse effects accounted for 10 of 20 discontinuations (50.0%) in the older group and 6 of 52 (11.5%) in the younger group. Herpes zoster incidence was higher among older patients (adjusted HR 1.94, 95% CI 1.02–3.71; p=0.044), with about half of cases occurring during the first treatment year. Concomitant methotrexate and glucocorticoid use were associated with subsequent discontinuation.
The findings support vigilance for herpes zoster in older patients, particularly early in treatment, but do not establish comparative cardiovascular or malignancy safety. The study was conducted at a single center, and its size and follow-up were insufficient to assess infrequent outcomes; it evaluated discontinuation reasons rather than systematically collected safety events.
In practice
For clinicians treating rheumatoid arthritis, this single-center cohort found no significant difference in overall JAK inhibitor retention between patients aged 65 years or older and younger patients, but herpes zoster incidence was higher in the older group (adjusted HR 1.94), with about half of cases in the first treatment year. This supports attention to zoster during early treatment in older patients, but does not establish broader safety differences: the study recorded discontinuation reasons rather than systematically ascertained adverse events and was underpowered for infrequent cardiovascular or malignancy outcomes.
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Clinical Rheumatology: JAK inhibitor retention and adverse event–related discontinuation in elderly patients with rheumatoid arthritis: a real-world cohort study ↗This is an automated AI-condensed summary that has not yet been reviewed by an editor. Always consult the full item at the original source.