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Drug Retention Rates of Janus Kinase Inhibitors in Rheumatoid Arthritis Patients with Therapy-Induced Lymphopenia

Objectives: To determine whether drug-induced lymphocytopenia is associated with drug retention rates of JAKi (tofacitinib or baricitinib) in rheumatoid arthritis (RA) patients. Methods: Patients with RA who were initiated with tofacitinib (n = 38) or baricitinib (n = 74) between July 2015 and July...

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Autores principales: Temmoku, Jumpei, Miyata, Masayuki, Suzuki, Eiji, Sumichika, Yuya, Saito, Kenji, Yoshida, Shuhei, Matsumoto, Haruki, Fujita, Yuya, Matsuoka, Naoki, Asano, Tomoyuki, Sato, Shuzo, Watanabe, Hiroshi, Migita, Kiyoshi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381502/
https://www.ncbi.nlm.nih.gov/pubmed/37510940
http://dx.doi.org/10.3390/jcm12144827
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author Temmoku, Jumpei
Miyata, Masayuki
Suzuki, Eiji
Sumichika, Yuya
Saito, Kenji
Yoshida, Shuhei
Matsumoto, Haruki
Fujita, Yuya
Matsuoka, Naoki
Asano, Tomoyuki
Sato, Shuzo
Watanabe, Hiroshi
Migita, Kiyoshi
author_facet Temmoku, Jumpei
Miyata, Masayuki
Suzuki, Eiji
Sumichika, Yuya
Saito, Kenji
Yoshida, Shuhei
Matsumoto, Haruki
Fujita, Yuya
Matsuoka, Naoki
Asano, Tomoyuki
Sato, Shuzo
Watanabe, Hiroshi
Migita, Kiyoshi
author_sort Temmoku, Jumpei
collection PubMed
description Objectives: To determine whether drug-induced lymphocytopenia is associated with drug retention rates of JAKi (tofacitinib or baricitinib) in rheumatoid arthritis (RA) patients. Methods: Patients with RA who were initiated with tofacitinib (n = 38) or baricitinib (n = 74) between July 2015 and July 2022 and continued for at least 4 months were enrolled in this study. Absolute lymphocyte count (ALC) value was obtained pre-treatment and monthly after initiation of JAKi (up to 4 months). Associations between ALC nadir at an early phase (up to 4 months) from JAKi initiation and drug retention rates were analysed. Results: 112 patients (87 females; age, 71.2 ± 14.0 years; disease duration, 9.2 ± 10.5 months; DAS28-CRP, 3.60 ± 1.12; DAS28-ESR, 4.43 ± 1.29; CDAI, 17.9 ± 12.9; C-reactive protein, 3.07 ± 3.43 mg/dL; and lymphocyte count, 1361.9 ± 538.7 per μL) treated with tofacitinib or baricitinib were retrospectively analysed. Lymphocytopenia (>10% decline in lymphocyte count to pre-treatment basal levels) was observed in a quarter of RA patients treated with JAKi (tofacitinib; 16 baricitinib; 14). RA patients with lymphopenia were associated with the lower drug retention rates of tofacitinib compared to those without lymphocytopenia. The reduced drug retention rates in patients with lymphocytopenia were attributed to the discontinuation of tofacitinib due to AEs. Whereas lymphocytopenia was not associated with lower drug retention rates of baricitinib. Pre-treatment absolute lymphocyte counts did not affect the drug retention rates of JAKi in patients with RA. Conclusions: These findings suggest that lymphopenia during the first 4 months from the initiation of JAKi is associated with reduced drug retention rates in patients with RA due to AEs, which is exclusively associated with the use of tofacitinib.
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spelling pubmed-103815022023-07-29 Drug Retention Rates of Janus Kinase Inhibitors in Rheumatoid Arthritis Patients with Therapy-Induced Lymphopenia Temmoku, Jumpei Miyata, Masayuki Suzuki, Eiji Sumichika, Yuya Saito, Kenji Yoshida, Shuhei Matsumoto, Haruki Fujita, Yuya Matsuoka, Naoki Asano, Tomoyuki Sato, Shuzo Watanabe, Hiroshi Migita, Kiyoshi J Clin Med Article Objectives: To determine whether drug-induced lymphocytopenia is associated with drug retention rates of JAKi (tofacitinib or baricitinib) in rheumatoid arthritis (RA) patients. Methods: Patients with RA who were initiated with tofacitinib (n = 38) or baricitinib (n = 74) between July 2015 and July 2022 and continued for at least 4 months were enrolled in this study. Absolute lymphocyte count (ALC) value was obtained pre-treatment and monthly after initiation of JAKi (up to 4 months). Associations between ALC nadir at an early phase (up to 4 months) from JAKi initiation and drug retention rates were analysed. Results: 112 patients (87 females; age, 71.2 ± 14.0 years; disease duration, 9.2 ± 10.5 months; DAS28-CRP, 3.60 ± 1.12; DAS28-ESR, 4.43 ± 1.29; CDAI, 17.9 ± 12.9; C-reactive protein, 3.07 ± 3.43 mg/dL; and lymphocyte count, 1361.9 ± 538.7 per μL) treated with tofacitinib or baricitinib were retrospectively analysed. Lymphocytopenia (>10% decline in lymphocyte count to pre-treatment basal levels) was observed in a quarter of RA patients treated with JAKi (tofacitinib; 16 baricitinib; 14). RA patients with lymphopenia were associated with the lower drug retention rates of tofacitinib compared to those without lymphocytopenia. The reduced drug retention rates in patients with lymphocytopenia were attributed to the discontinuation of tofacitinib due to AEs. Whereas lymphocytopenia was not associated with lower drug retention rates of baricitinib. Pre-treatment absolute lymphocyte counts did not affect the drug retention rates of JAKi in patients with RA. Conclusions: These findings suggest that lymphopenia during the first 4 months from the initiation of JAKi is associated with reduced drug retention rates in patients with RA due to AEs, which is exclusively associated with the use of tofacitinib. MDPI 2023-07-21 /pmc/articles/PMC10381502/ /pubmed/37510940 http://dx.doi.org/10.3390/jcm12144827 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Temmoku, Jumpei
Miyata, Masayuki
Suzuki, Eiji
Sumichika, Yuya
Saito, Kenji
Yoshida, Shuhei
Matsumoto, Haruki
Fujita, Yuya
Matsuoka, Naoki
Asano, Tomoyuki
Sato, Shuzo
Watanabe, Hiroshi
Migita, Kiyoshi
Drug Retention Rates of Janus Kinase Inhibitors in Rheumatoid Arthritis Patients with Therapy-Induced Lymphopenia
title Drug Retention Rates of Janus Kinase Inhibitors in Rheumatoid Arthritis Patients with Therapy-Induced Lymphopenia
title_full Drug Retention Rates of Janus Kinase Inhibitors in Rheumatoid Arthritis Patients with Therapy-Induced Lymphopenia
title_fullStr Drug Retention Rates of Janus Kinase Inhibitors in Rheumatoid Arthritis Patients with Therapy-Induced Lymphopenia
title_full_unstemmed Drug Retention Rates of Janus Kinase Inhibitors in Rheumatoid Arthritis Patients with Therapy-Induced Lymphopenia
title_short Drug Retention Rates of Janus Kinase Inhibitors in Rheumatoid Arthritis Patients with Therapy-Induced Lymphopenia
title_sort drug retention rates of janus kinase inhibitors in rheumatoid arthritis patients with therapy-induced lymphopenia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10381502/
https://www.ncbi.nlm.nih.gov/pubmed/37510940
http://dx.doi.org/10.3390/jcm12144827
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