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The following is a summary of “Efficacy and safety of first-line targeted synthetic DMARDs in rheumatoid arthritis patients with chronic kidney disease,” published in the January 2025 issue of Rheumatology by Yoshimura et al.
Researchers conducted a retrospective study on the efficacy and safety of first-line targeted synthetic DMARDs in patients with rheumatoid arthritis (RA) and chronic kidney disease (CKD).
They analyzed 216 patients with RA prescribed their first tsDMARDs at 2 hospitals (2013–2022). Patients were grouped by kidney function and tsDMARD type, following dose reduction guidelines. Primary outcome: 24-month drug retention rate; secondary outcomes: DAS28-CRP changes, prednisolone dosage, and discontinuation reasons.
The results showed 24-month drug retention rates for all tsDMARDs were 46.0%, 44.1%, and 47.1% for estimated glomerular filtration rate (eGFR) ≥60, 30–60, and <30 mL/min/1.73 m2, respectively. For tofacitinib, rates were 55.9%, 53.3%, and 66.7%; for baricitinib, 64.2% and 42.0%; and for peficitinib, 36.4%, 44.1%, and 40.0%. DAS28-CRP and prednisolone dosage decreased (P<0.01), and herpes zoster and deep vein thrombosis (DVT) incidence was higher with eGFR <30 mL/min/1.73 m2 but not significant.
Investigators demonstrated that tsDMARDs were effective and safe for patients with RA and CKD. However, they advised caution for herpes zoster and DVT risks in those with eGFR <30 mL/min/1.73 m2.
Source: academic.oup.com/rheumatology/advance-article-abstract/doi/10.1093/rheumatology/keaf050/7979251
