Mortality and medical utilization in rheumatoid arthritis associated interstitial lung disease: A real-world, large-scale retrospective study comparing Janus kinase inhibitors and tumor necrosis factor inhibitors
Objective: The study is aimed to investigate the effectiveness of Janus kinase inhibitors (JAKi) on rheumatoid arthritis associated interstitial lung disease (RA-ILD) compared to tumor necrosis inhibitors (TNFi). Methods: We applied a retrospective matched cohort analysis using the TriNetX database. The study included patients diagnosed with RA-ILD who received new prescriptions for JAKi or TNFi. The primary outcome was all- cause mortality, and secondary outcomes included medical utilizations. Hazard ratios (HRs) and Cox regression analyses were performed to assess these outcomes. Results: Among 23,707 RA-ILD patients, 812 were selected for each treatment group (JAKi and TNFi) following propensity score matching. The JAKi group exhibited a higher all-cause mortality risk compared to the TNFi group (HR 1.458, 95 % CI: 1.136-1.870). JAKi group was also associated with a higher risk for hospitalization (HR 1.167, 95 % CI: 1.011-1.348), critical care services (HR 1.854, 95 % CI: 1.414-2.431), and mechanical ventilation (HR 2.609, 95 % CI: 1.718-3.962). Subgroup analysis indicated a heightened mortality risk in JAKitreated patients aged over 65 years old (HR 1.815, 95 % CI: 1.316-2.503), and those with cardiovascular risk factors (HR 1.636, 95 % CI: 1.197-2.237). Sensitivity analysis yielded results that were not entirely consistent with the primary analysis, except for the subgroup aged over 65, where results remained aligned. Conclusion: This real-world, large-scale cohort study indicated an association of higher mortality and medical utilizations in RA-ILD patients treated with JAKi compared to TNFi, especially among those over 65 years of age. These findings highlight the need for careful assessment when prescribing JAKi or TNFi for patients with RA-ILD.
第一作者机构：[1]Chung Shan Med Univ, Inst Med, 110,Sect 1,Jianguo North Rd, Taichung 402, Taiwan[2]Changhua Christian Hosp, Dept Internal Med, Div Allergy Immunol & Rheumatol, Changhua, Taiwan
共同第一作者：
通讯作者：
通讯机构：[1]Chung Shan Med Univ, Inst Med, 110,Sect 1,Jianguo North Rd, Taichung 402, Taiwan[7]Sichuan Univ, West China Sch Publ Hlth, Dept Rheumatol & Immunol, Chengdu, Peoples R China[8]Sichuan Univ, West China Hosp 4, Chengdu, Peoples R China[9]Third Hosp Shanxi Med Univ, Shanxi Bethune Hosp, Tongji Shanxi Hosp, Tongji Shanxi Hosp,Shanxi Acad Med Sci, Taiyuan, Peoples R China[10]Chung Shan Med Univ Hosp, Dept Allergy Immunol & Rheumatol, Taichung, Taiwan[11]Asia Univ, Off Res & Dev, Taichung, Taiwan[12]China Med Univ, Grad Inst Integrated Med, Taichung, Taiwan
推荐引用方式(GB/T 7714)：
Shih Po-Cheng,Zou Qing-Hua,Lai Chih-Cheng,et al.Mortality and medical utilization in rheumatoid arthritis associated interstitial lung disease: A real-world, large-scale retrospective study comparing Janus kinase inhibitors and tumor necrosis factor inhibitors[J].SEMINARS IN ARTHRITIS AND RHEUMATISM.2025,71:doi:10.1016/j.semarthrit.2025.152636.
APA：
Shih, Po-Cheng,Zou, Qing-Hua,Lai, Chih-Cheng,Wang, Shiow-Ing,Huang, Xiang-Yang&Wei, James Cheng Chung.(2025).Mortality and medical utilization in rheumatoid arthritis associated interstitial lung disease: A real-world, large-scale retrospective study comparing Janus kinase inhibitors and tumor necrosis factor inhibitors.SEMINARS IN ARTHRITIS AND RHEUMATISM,71,
MLA：
Shih, Po-Cheng,et al."Mortality and medical utilization in rheumatoid arthritis associated interstitial lung disease: A real-world, large-scale retrospective study comparing Janus kinase inhibitors and tumor necrosis factor inhibitors".SEMINARS IN ARTHRITIS AND RHEUMATISM 71.(2025)
