Why carry out this study?

In patients with rheumatoid arthritis (RA), clinical practice guidelines recommend switching from a biologic (b) or targeted synthetic (ts) disease-modifying anti-rheumatic drug (DMARD) to another b/tsDMARD with an alternative mechanism of action (without preference to any class) in case the treatment target is not achieved.

Although data exist for the effect on clinical outcomes while switching from a tumor necrosis factor inhibitor (TNFi) to another b/tsDMARD, there is limited research on switching between an interleukin-6 receptor inhibitor (IL-6Ri) and a Janus kinase inhibitor (JAKi), given both classes act on the IL-6 pathway.

What was learned from this study?

This observational study showed improvement in clinical outcomes when switching patients with RA from an IL-6Ri to a JAKi (and vice versa), and the responses were generally comparable between the two groups, indicating that the healthcare providers may consider such switch, without concerns that commonalities in their mode of action may hamper clinical effectiveness.

This is the first study to measure clinical outcomes when switching from an IL-6Ri to a JAKi and from a JAKi to an IL-6Ri in the same patient population and suggests that the distinct mechanisms of action of the two classes account for the observed clinical responses.