Background: In the field of rheumatology, there are five primary classes of advanced therapy treatments that are crucial for addressing key indications. These include TNFi, JAKi, IL6i, CD80i, and CD20i. Should a treatment response not be sustained with csDMARDs like methotrexate, it is recommended by the EULAR guidelines to consider the utilization of advanced therapies for patients. However, it is important to take into account specific risk factors when using Janus Kinase inhibitors (JAKi).

Objectives: The purpose of this was study was to evaluate whether physicians utilize JAKi treatment at similar levels for the rheumatology indications of Rheumatoid Arthritis (RA), Psoriatic Arthritis (PsA), and Axial Spondyloarthritis (axSpA). We aimed to determine if there is a halo effect, whereby the use of JAKi in one indication influences its usage in another, and if this relationship has evolved over time.

Methods: In Q4 of 2023, 228 Rheumatologists from France, Italy, Germany, Spain, and the UK contributed approximately 3420 anonymous patient record forms for individuals receiving advanced therapy. These forms consisted of 1600 records for RA patients, 912 for PsA patients, and an additional 912 for axSpA patients, all of which were collected through the Therapy Watch Rheumatology survey by Research Partnership. Informed consent from physicians was obtained. Where relevant, statistical comparisons were performed using t-test.

Results: 35% of physicians reported exclusive use of JAKi for RA treatment, while 44% prescribe JAKi for RA in combination with either PsA, axSpA, or both. Very few physicians prescribe JAKi to PsA or axSpA patients, indicating a halo effect originating from RA use.

18% of physicians do not report JAKi use in any indication across EU5. In Germany, 7.3% physicians did not report JAKi use in any indication in Q2 2022, rising to 19.6% in Q4 2023.

The percentage of physicians not using JAKi in the treatment of RA has increased from 15.4% in Q1 2022 to 21.9% in Q4 2023. On the other hand, the prescribing of JAKi for PsA and axSpA is significantly lower than in RA, but remains relatively stable.

Conclusion: Our findings reveal a halo effect when it comes to the use of JAKi in RA, which extends to its usage in PsA and axSpA. Very few physicians prescribe JAKi solely for PsA or axSpA patients.

Our data confirms that the utilization of JAKi in PsA and axSpA patients is typically linked to its usage by physicians in RA. However, there is a growing trend among physicians who have stopped prescribing JAKi for RA following the PRAC guidance announcements. At this point, our data suggests that this change has not had a ripple effect on the prescribing of JAKi for PsA and axSpA.

REFERENCES: NIL.

Acknowledgements: NIL.

Disclosure of Interests: None declared.