Real-Life Use of Filgotinib in Rheumatoid arthritis:A Retrospective Cohort Study

Background: In the aftermath of the ORAL Surveillance trial, real-world studies are needed to elucidate the effectiveness and safety of Janus kinase inhibitors (JAKis) in routine clinical practice. Methods: We performed a multicenter, retrospective cohort study investigating the real-life effectiveness and safety of filgotinib, a novel JAK1 inhibitor, in adult patients with rheumatoid arthritis (RA). Demographic information, disease characteristics, prior treatment history, and comorbid conditions, were retrieved from clinical records at baseline (T0) and after 3 (T3) and 6 months (T6) of treatment. Results: A total of 82 patients (63 women) agreed to participate in the study, of which 39 (47.6%) were older than 65 years. Average RA duration was 13 ± 9 years; 19 patients (23.1%) were current or former smokers and 4 patients (4.9%) had a past history of cardiovascular events. Most patients had previously received at least one biologic disease-modifying antirheumatic drug (range: 1–6+); in addition, 11 patients (13.4%) had been already exposed to another JAKi. During the follow-up, 7 patients discontinued treatment due to primary failure (n = 3) or adverse events (n = 4). Significant reductions in pain and number of tender and swollen joints were observed at T3 and T6. A relevant proportion of patients achieved DAS28-CRP remission at T3 and T6 (46.3% and 66.2%, respectively). Conclusion: Our data provide additional insight into the effectiveness and safety of filgotinib in a real-world setting, even among patients with difficult-to-treat RA and a high prevalence of cardiovascular risk factors.