Switching biological disease-modifying antirheumatic drugs and Janus kinase inhibitors in patients with rheumatoid arthritis

The goal of treatment of rheumatoid arthritis (RA) is to achieve remission or low disease activity. A wide range of disease-modifying antirheumatic drugs is used for the treatment of RA, including biological disease-modifying antirheumatic drugs (bDMARDs) and Janus kinase inhibitors (JAKi). However,...

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Main Authors: A. O. Bobkova, A. M. Lila
Format: Article
Language:Russian
Published: IMA-PRESS LLC 2023-07-01
Series:Современная ревматология
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Online Access:https://mrj.ima-press.net/mrj/article/view/1436
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author A. O. Bobkova
A. M. Lila
author_facet A. O. Bobkova
A. M. Lila
author_sort A. O. Bobkova
collection DOAJ
description The goal of treatment of rheumatoid arthritis (RA) is to achieve remission or low disease activity. A wide range of disease-modifying antirheumatic drugs is used for the treatment of RA, including biological disease-modifying antirheumatic drugs (bDMARDs) and Janus kinase inhibitors (JAKi). However, even with the use of bDMARDs and JAKi, this goal can be achieved only in 40–60% of patients. Insufficient response to bDMARs and JAKi is the reason for switching to other drugs from the same group, such as tumor necrosis factor-α inhibitors, and to drugs with a different mechanism of action. The need to change therapy may be associated with its ineffectiveness due to various immune, genetic and epigenetic mechanisms, with the development of adverse reactions, as well as with comorbid pathology. To date, there is no certain predictors of effectiveness of a particular bDMARDs and JAKi and of the need and strategy for changing the therapy.The review considers the effectiveness of various classes of bDMARDs and JAKi in RA, the frequency and risk factors associated with the need to switch patients to other drugs, the role of chemokines as promising markers of response to RA treatment.
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spelling doaj-art-697e4dbd282f4a55b9369fb89dcfd7e22025-08-20T03:01:21ZrusIMA-PRESS LLCСовременная ревматология1996-70122310-158X2023-07-01173828810.14412/1996-7012-2023-3-82-882588Switching biological disease-modifying antirheumatic drugs and Janus kinase inhibitors in patients with rheumatoid arthritisA. O. Bobkova0A. M. Lila1V.A. Nasonova Research Institute of RheumatologyV.A. Nasonova Research Institute of Rheumatology; Russian Medical Academy of Continuing Professional EducationThe goal of treatment of rheumatoid arthritis (RA) is to achieve remission or low disease activity. A wide range of disease-modifying antirheumatic drugs is used for the treatment of RA, including biological disease-modifying antirheumatic drugs (bDMARDs) and Janus kinase inhibitors (JAKi). However, even with the use of bDMARDs and JAKi, this goal can be achieved only in 40–60% of patients. Insufficient response to bDMARs and JAKi is the reason for switching to other drugs from the same group, such as tumor necrosis factor-α inhibitors, and to drugs with a different mechanism of action. The need to change therapy may be associated with its ineffectiveness due to various immune, genetic and epigenetic mechanisms, with the development of adverse reactions, as well as with comorbid pathology. To date, there is no certain predictors of effectiveness of a particular bDMARDs and JAKi and of the need and strategy for changing the therapy.The review considers the effectiveness of various classes of bDMARDs and JAKi in RA, the frequency and risk factors associated with the need to switch patients to other drugs, the role of chemokines as promising markers of response to RA treatment.https://mrj.ima-press.net/mrj/article/view/1436rheumatoid arthritisbiological disease-modifying antirheumatic drugsjak inhibitorsswitchingrisk factorschemokines
spellingShingle A. O. Bobkova
A. M. Lila
Switching biological disease-modifying antirheumatic drugs and Janus kinase inhibitors in patients with rheumatoid arthritis
Современная ревматология
rheumatoid arthritis
biological disease-modifying antirheumatic drugs
jak inhibitors
switching
risk factors
chemokines
title Switching biological disease-modifying antirheumatic drugs and Janus kinase inhibitors in patients with rheumatoid arthritis
title_full Switching biological disease-modifying antirheumatic drugs and Janus kinase inhibitors in patients with rheumatoid arthritis
title_fullStr Switching biological disease-modifying antirheumatic drugs and Janus kinase inhibitors in patients with rheumatoid arthritis
title_full_unstemmed Switching biological disease-modifying antirheumatic drugs and Janus kinase inhibitors in patients with rheumatoid arthritis
title_short Switching biological disease-modifying antirheumatic drugs and Janus kinase inhibitors in patients with rheumatoid arthritis
title_sort switching biological disease modifying antirheumatic drugs and janus kinase inhibitors in patients with rheumatoid arthritis
topic rheumatoid arthritis
biological disease-modifying antirheumatic drugs
jak inhibitors
switching
risk factors
chemokines
url https://mrj.ima-press.net/mrj/article/view/1436
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