Are all JAK inhibitors for the treatment of rheumatoid arthritis equivalent? An adjusted indirect comparison of the efficacy of tofacitinib, baricitinib, upadacitinib, and filgotinib
Introduction: Comparisons of Janus kinase inhibitors (JAKi) for treatment of rheumatoid arthritis in patients with inadequate response to biologic disease-modifying anti-rheumatic drugs are lacking. We assessed the relative efficacy and safety of four JAKi (tofacitinib, baricitinib, upadacitinib, an...
| Authors: | ; ; ; ; ; ; ; ; |
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| Format: | Article |
| Publication date: | 2023 |
| Country: | España |
| Institution: | Universitat Autònoma de Barcelona |
| Repository: | Dipòsit Digital de Documents de la UAB |
| Language: | English |
| OAI Identifier: | oai:ddd.uab.cat:302730 |
| Online Access: | https://ddd.uab.cat/record/302730 https://dx.doi.org/urn:doi:10.1007/s10067-023-06787-2 |
| Access Level: | Open access |
| Keyword: | Rheumatoid arthritis Indirect comparison Janus Kinase inhibitors Equivalent therapeutic alternatives |
| _version_ | 1878729270930440192 |
|---|---|
| author | Vallez-Valero, Lucía|||0000-0001-9163-302X |
| author2 | Gasó-Gago, Ingrid Marcos Fendian, Ángel|||0000-0003-2595-5906 Garrido-Alejos, Gemma|||0000-0001-8249-2771 Riera-Magallón, Adrià Plaza Díaz, Adrián|||0000-0002-5316-5090 Martinez-Molina, Cristina|||0000-0001-5079-613X Mangues-Bafalluy, Maria Antònia Corominas, Hèctor|||0000-0002-7738-6787 |
| author2_role | author author author author author author author author |
| author_browse | Corominas, Hèctor|||0000-0002-7738-6787 Garrido-Alejos, Gemma|||0000-0001-8249-2771 Gasó-Gago, Ingrid Mangues-Bafalluy, Maria Antònia Marcos Fendian, Ángel|||0000-0003-2595-5906 Martinez-Molina, Cristina|||0000-0001-5079-613X Plaza Díaz, Adrián|||0000-0002-5316-5090 Riera-Magallón, Adrià Vallez-Valero, Lucía|||0000-0001-9163-302X |
| author_facet | Vallez-Valero, Lucía|||0000-0001-9163-302X Gasó-Gago, Ingrid Marcos Fendian, Ángel|||0000-0003-2595-5906 Garrido-Alejos, Gemma|||0000-0001-8249-2771 Riera-Magallón, Adrià Plaza Díaz, Adrián|||0000-0002-5316-5090 Martinez-Molina, Cristina|||0000-0001-5079-613X Mangues-Bafalluy, Maria Antònia Corominas, Hèctor|||0000-0002-7738-6787 |
| author_role | author |
| collection | Dipòsit Digital de Documents de la UAB |
| description | Introduction: Comparisons of Janus kinase inhibitors (JAKi) for treatment of rheumatoid arthritis in patients with inadequate response to biologic disease-modifying anti-rheumatic drugs are lacking. We assessed the relative efficacy and safety of four JAKi (tofacitinib, baricitinib, upadacitinib, and filgotinib) in this context. Method: We performed an adjusted indirect comparison (IC) of randomized clinical trials using Bucher's method with an IC and mixed calculator. Endpoints were Disease Activity Score C-reactive protein (DAS28-CRP) and American College of Rheumatology-20 (ACR20). Equivalence was assessed using the equivalent therapeutic alternatives (ETA) guidelines. Results: We included four of 133 potentially relevant studies. IC showed no statistically significant differences between the four JAKi regarding DAS28-CRP < 3.2. Results were similar in terms of ACR20 except for tofacitinib showing lower efficacy than upadacitinib (RAR -18.4% [IC95% -33.4 to -3.5], p=0.0157). Statistically significant differences were related to the relevant difference for tofacitinib in both endpoints. Despite no statistical differences for baricitinib, we observed a probably clinically relevant difference regarding DAS28-CRP. Probably clinically relevant differences were found for tofacitinib vs. upadacitinib in both endpoints, and for baricitinib vs. upadacitinib in DAS28-CRP. Safety, drug-drug interactions, and convenience considerations did not modify the result of therapeutic equivalence assessment based on efficacy data. Conclusions: In conclusion, our results show that filgotinib and upadacitinib are ETA. Baricitinib and upadacitinib are also ETA due to a lack of clear differences and for showing superiority over placebo. The results for tofacitinib and upadacitinib show some inconsistency and more data are needed. Key Points • To date, neither a head-to-head comparison nor an indirect comparison between the Janus kinase inhibitors has been performed in patients with rheumatoid arthritis and an inadequate response to biologic disease-modifying anti-rheumatic drugs. • We performed an adjusted indirect comparison that included randomized clinical trials of tofacitinib, baricitinib, upadacitinib, and filgotinib to assess their equivalence in this scenario. • Our results show that baricitinib and filgotinib are equivalent therapeutic alternatives compared to upadacitinib. However, there is some inconsistency in the results of tofacitinib in front of upadacitinib. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | ES_04a981c3e7547b3fa2b8f70e2caaaa3d |
| institution | Universitat Autònoma de Barcelona |
| instname_str | Universitat Autònoma de Barcelona |
| language | eng |
| network_acronym_str | ES |
| network_name_str | España |
| oai_identifier_str | oai:ddd.uab.cat:302730 |
| publishDate | 2023 |
| publishDateSort | 2023 |
| reponame_str | Dipòsit Digital de Documents de la UAB |
| spelling | Are all JAK inhibitors for the treatment of rheumatoid arthritis equivalent? An adjusted indirect comparison of the efficacy of tofacitinib, baricitinib, upadacitinib, and filgotinib Vallez-Valero, Lucía|||0000-0001-9163-302X Gasó-Gago, Ingrid Marcos Fendian, Ángel|||0000-0003-2595-5906 Garrido-Alejos, Gemma|||0000-0001-8249-2771 Riera-Magallón, Adrià Plaza Díaz, Adrián|||0000-0002-5316-5090 Martinez-Molina, Cristina|||0000-0001-5079-613X Mangues-Bafalluy, Maria Antònia Corominas, Hèctor|||0000-0002-7738-6787 Rheumatoid arthritis Indirect comparison Janus Kinase inhibitors Equivalent therapeutic alternatives Introduction: Comparisons of Janus kinase inhibitors (JAKi) for treatment of rheumatoid arthritis in patients with inadequate response to biologic disease-modifying anti-rheumatic drugs are lacking. We assessed the relative efficacy and safety of four JAKi (tofacitinib, baricitinib, upadacitinib, and filgotinib) in this context. Method: We performed an adjusted indirect comparison (IC) of randomized clinical trials using Bucher's method with an IC and mixed calculator. Endpoints were Disease Activity Score C-reactive protein (DAS28-CRP) and American College of Rheumatology-20 (ACR20). Equivalence was assessed using the equivalent therapeutic alternatives (ETA) guidelines. Results: We included four of 133 potentially relevant studies. IC showed no statistically significant differences between the four JAKi regarding DAS28-CRP < 3.2. Results were similar in terms of ACR20 except for tofacitinib showing lower efficacy than upadacitinib (RAR -18.4% [IC95% -33.4 to -3.5], p=0.0157). Statistically significant differences were related to the relevant difference for tofacitinib in both endpoints. Despite no statistical differences for baricitinib, we observed a probably clinically relevant difference regarding DAS28-CRP. Probably clinically relevant differences were found for tofacitinib vs. upadacitinib in both endpoints, and for baricitinib vs. upadacitinib in DAS28-CRP. Safety, drug-drug interactions, and convenience considerations did not modify the result of therapeutic equivalence assessment based on efficacy data. Conclusions: In conclusion, our results show that filgotinib and upadacitinib are ETA. Baricitinib and upadacitinib are also ETA due to a lack of clear differences and for showing superiority over placebo. The results for tofacitinib and upadacitinib show some inconsistency and more data are needed. Key Points • To date, neither a head-to-head comparison nor an indirect comparison between the Janus kinase inhibitors has been performed in patients with rheumatoid arthritis and an inadequate response to biologic disease-modifying anti-rheumatic drugs. • We performed an adjusted indirect comparison that included randomized clinical trials of tofacitinib, baricitinib, upadacitinib, and filgotinib to assess their equivalence in this scenario. • Our results show that baricitinib and filgotinib are equivalent therapeutic alternatives compared to upadacitinib. However, there is some inconsistency in the results of tofacitinib in front of upadacitinib. https://ddd.uab.cat/record/302730 https://dx.doi.org/urn:doi:10.1007/s10067-023-06787-2 |
| spellingShingle | Are all JAK inhibitors for the treatment of rheumatoid arthritis equivalent? An adjusted indirect comparison of the efficacy of tofacitinib, baricitinib, upadacitinib, and filgotinib Vallez-Valero, Lucía|||0000-0001-9163-302X Rheumatoid arthritis Indirect comparison Janus Kinase inhibitors Equivalent therapeutic alternatives |
| title | Are all JAK inhibitors for the treatment of rheumatoid arthritis equivalent? An adjusted indirect comparison of the efficacy of tofacitinib, baricitinib, upadacitinib, and filgotinib |
| title_full | Are all JAK inhibitors for the treatment of rheumatoid arthritis equivalent? An adjusted indirect comparison of the efficacy of tofacitinib, baricitinib, upadacitinib, and filgotinib |
| title_fullStr | Are all JAK inhibitors for the treatment of rheumatoid arthritis equivalent? An adjusted indirect comparison of the efficacy of tofacitinib, baricitinib, upadacitinib, and filgotinib |
| title_full_unstemmed | Are all JAK inhibitors for the treatment of rheumatoid arthritis equivalent? An adjusted indirect comparison of the efficacy of tofacitinib, baricitinib, upadacitinib, and filgotinib |
| title_short | Are all JAK inhibitors for the treatment of rheumatoid arthritis equivalent? An adjusted indirect comparison of the efficacy of tofacitinib, baricitinib, upadacitinib, and filgotinib |
| title_sort | Are all JAK inhibitors for the treatment of rheumatoid arthritis equivalent? An adjusted indirect comparison of the efficacy of tofacitinib, baricitinib, upadacitinib, and filgotinib |
| topic | Rheumatoid arthritis Indirect comparison Janus Kinase inhibitors Equivalent therapeutic alternatives |
| topic_facet | Rheumatoid arthritis Indirect comparison Janus Kinase inhibitors Equivalent therapeutic alternatives |
| url | https://ddd.uab.cat/record/302730 https://dx.doi.org/urn:doi:10.1007/s10067-023-06787-2 |