Full Papers
Effectiveness, survival and prescription patterns of Janus kinase inhibitors in rheumatoid arthritis: results of a 5.9-year follow-up from the Italian Study Group of Early Arthritis (GISEA) registry
G. Cincinelli1, E.G. Favalli2, M. Fornaro3, E. Gremese4, C. Bazzani5, A. Scalvini6, S. Bugatti7, F.R. Spinelli8, M. Sebastiani9, A. Cauli10, F.P. Cantatore11, R. Foti12, G. Lapadula13, G. Ferraccioli14, F. Conti15, F. Iannone16, R. Caporali17
- Department of Rheumatology and Medical Sciences, ASST G. Pini-CTO Milan, Italy. gilberto.cincinelli@asst-pini-cto.it
- Department of Rheumatology and Medical Sciences, ASST G. Pini-CTO Milan; and Department of Clinical Sciences and Community Health, University of Milan, Italy.
- Rheumatology Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Italy.
- Rheumatology and Clinical Immunology, IRCCS Humanitas Research Hospital, Rozzano, Milan; and Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan, Italy.
- Rheumatology and Clinical Immunology Unit, ASST Spedali Civili, Brescia, Italy.
- Rheumatology and Clinical Immunology Unit, ASST Spedali Civili, Brescia, Italy.
- Department of Internal Medicine and Therapeutics, Università di Pavia; and Division of Rheumatology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
- Rheumatology Unit, Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, Sapienza Università di Roma, Rome, Italy.
- Rheumatology Unit, Guglielmo da Saliceto Hospital, Azienda USL di Piacenza; and Department of Medicine and Surgery, University of Parma, Italy.
- Rheumatology Unit, Department of Medical Sciences and Public Health, AOU and University of Cagliari, Monserrato, Italy.
- Rheumatology Unit, University of Foggia, Italy.
- Division of Rheumatology, AOU Policlinico G. Rodolico San Marco, Catania, Italy.
- Gruppo Italiano di Studio sulla early Arthritis, GISEA, Bari, Italy.
- Department of Medicine, Universita’ Cattolica del Sacro Cuore, Fondazione IRCCS Policlinico Gemelli, Rome, Italy.
- Rheumatology Unit, Dipartimento di Scienze Cliniche Internistiche, Anestesiologiche e Cardiovascolari, Sapienza Università di Roma, Rome, Italy.
- Rheumatology Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari, Italy.
- Department of Rheumatology and Medical Sciences, ASST G. Pini-CTO Milan; and Department of Clinical Sciences and Community Health, University of Milan, Italy.
CER20002
Full Papers
PMID: 42873705 [PubMed]
Received: 03/04/2026
Accepted : 26/06/2026
In Press: 14/10/2026
Abstract
OBJECTIVES:
Janus kinase inhibitors (JAKis) have emerged as a valuable treatment option for rheumatoid arthritis (RA). Still, real-world data on their retention and prescription patterns are crucial, especially considering guideline updates. This study aimed to evaluate these aspects in a large Italian RA cohort.
METHODS:
Patients with a diagnosis of RA enrolled in the Italian Study Group on Early Arthritis (GISEA) registry initiating JAKi therapy were included. Demographic and clinical characteristics, disease activity scores and treatment survival were assessed at baseline, at 6, 12, and 24 months and at last available visit or at drug discontinuation. Log-Rank tests and Cox regression analysis were employed to assess drugs survival and factors associated with discontinuation. Prescription patterns and patients selection were analysed across three periods reflecting key events in JAKi utilisation.
RESULTS:
1303 patients were included. JAKi retention rates at 6, 12, and 24 months were 80.9%, 74.9%, and 61.1%, respectively. Glucocorticoid use, higher disease activity, and significant pain at baseline were associated with shorter retention. Conversely, first-line JAKi therapy after csDMARD failure was associated with longer retention. Prescription patterns shifted over time, with a trend towards earlier JAKi use among younger patients with established disease, and a more cautious approach following safety warnings, including reduced first-line use and less combination therapy.
CONCLUSIONS:
This large real-world study confirms the effectiveness of JAKis in RA, with valuable insights into factors influencing treatment survival and evolving prescription trends.
