1Entesar Nuri Etrug, 2Ahmed Salem Zayat
1University Hospital Sharjah, 2University Of Sharjah
Background:
JAK inhibitors have an increasing role in treating different arthropathies and provide an oral targeted synthetic effective therapeutic option in moderate to severe rheumatoid, psoriatic arthritis and ankylosing spondylitis. The role of selectivity of different JAK on efficacy and drug retention is yet unknown and side effects profile among Arabs and other ethnic group in UAE is still no reported. The objective was to assess the difference in retention rate among different JAKs and the profile of side effects reported by Emirati and non-Emirati patients.
Method(s):
We used registry data of patients at University hospital Sharjah to perform a retrospective analysis of electronic patients records (EPR)received JAK inhibitors over the last 3 years. Descriptive analysis was performed to assess retention rates, reported side effects and other co-morbidities and events occurred after the initiation.
Result(s):
40 patients received either baricitinib or upadacitinib (Figure 1). The mean age (range was 62 (30-82) and 57 (30-92) years for barcitinib and upadacitinib respectively and 90% were females. 92.5% of the patients were Emirati and the remaining 7.5% were Arabs of different nationalities (Table 1 for patients characteristics). The retention rate for baricitinib was 47% while for upadacitinib was 40%. There was more patient sustained remission (88%) on baricitinib in comparison to (44%) on upadacitinib, however, there were more patients who started barcitinib as b-DMARD naïve (82%) than upadacitinib (46%). The reason for discontinuation was primary failure in 34% in both drugs. Among those who discontinued the drugs 22% and 33% of patient discontinued baricitinib and upadactinib respectively for secondary failure and 33% and 25% stopped baricitinib and upadactinib respectively because of side effects. Although 75% of patients were ≥ 50 years and 35% ≥ 65 years old where 22.5% had ≥ 1 cardiovascular risk factor but no one sustained MACE or VTE. Only 1 patient had arterial thromboembolism on upadacitinib with risk factors of obesity and >65 years old. Herpes Zoster occurred in 1 patient only in each group (5.8% of baricitinib and 4.5% of upadactinib) and all were > 60 years old. Generally, there were more side effects reported with upadacitinib 6 (27%) versus 3 (17%) in baricitinib
Conclusion(s):
There was good retention rate and frequency of patients achieving remission on JAK inhibitors with some differences noted which could be linked to the line of therapies given and background diagnosis. The profile of side effects was similar to what been reported by previous phase 3 clinical trials. There was no MACE/ VTE in Emiratis in this cohort even with older ages and cardiovascular risk factor, however, larger number and multicenter registry data will be required to draw conclusions.