Why carry out this study?

JAK inhibitors are a class of targeted therapies for treating patients with moderate-to-severe rheumatoid arthritis (RA) who have an inadequate response to csDMARDs (csDMARD-IR).

Because of the absence of direct head-to-head studies, comparative efficacy data between the currently approved JAK inhibitors - tofacitinib, baricitinib, and upadacitinib is limited.

This network meta-analysis (NMA) compared ACR20/50/70 and DAS28-CRP remission outcomes at 12- and 24-weeks for all JAK inhibitors currently approved for the treatment of RA.

What was learned from the study?

The results indicated that upadacitinib 15 mg once daily + csDMARD had numerically the highest ACR responses and DAS28-CRP remission rates among all combination therapies at both 12 and 24 weeks and among monotherapies, ACR responses with upadacitinib 15 mg once daily were numerically higher than those with tofacitinib 5 mg twice daily.

The study helps in better understanding of the comparative efficacy of the three approved JAKs via an indirect treatment comparison approach. Given the lack of H2H trials between the three JAKs, the study findings study findings could provide insights to physicians and payers in treatment and reimbursement decision making.