The steroid-sparing effect of JAK inhibitors across multiple patient populations

Introduction JAK-inhibitors (JAK-i) represent an effective treatment in rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Oral glucocorticoids (OGC) are commonly used in combination with JAK-i to reach therapeutic target. we aimed to assess, in a real-life setting, the reduction of OGC dose during JAK-i treatment in active RA and PsA patients.methods we prospectively enrolled 103 patients (88 RA, 15 PsA) treated with JAK-i: 24% bio-na & iuml;ve (b-na & iuml;ve), 76% bDMARD-insufficient responders (bDMARD-IR) and 40% difficult to treat (D2T), defined as failure of >= 2 bDMARDs with different mechanism of action. disease activity (DAS28 and DAPSA, VAS-pain, GH) and OGC dose was collected at baseline and after 3, 6 and 12 months (T3, T6, T12) of treatment. results In all the cohort and in b-na & iuml;ve patients we reported a reduction of OGC dose at all time-points; bDMARD-IR patients were able to reduce OGC dose at T3 and T12; D2T ones only at T3. we reported an improvement of disease activity and withdrawal of OGC as early as three months of therapy, at all time-points, regardless of line of bDMARD treatment.conclusion chronic OGC may cause detrimental bone, metabolic, cardiovascular side effects and infections; therefore JAK-i steroid-sparing effect may be beneficial for patients in long-term treatment.