TY - JOUR
T1 - WHY most (but perhaps not all) DMARDs work equally well
AU - Landewé, Robert B. M.
AU - Sepriano, Alexandre
AU - Bergstra, Sytske Anne
N1 - Publisher Copyright: © 2023 The Author(s)
PY - 2024/2
Y1 - 2024/2
N2 - Biological- or targeted-synthetic DMARD-responses reported in randomized clinical trials, placebo-controlled or head-to-head, in patients with rheumatoid arthritis, psoriatic arthritis or spondyloarthritis are unbelievably similar, when looking across trials performed in the same disease and applying the same primary outcome measures. The exception to this rule may be the response to Janus-kinase-inhibitors, which seem to work 10 % better in all trials (JAK-bonus) This article provides a potential explanation for this remarkable phenomenon, including an explanation for the JAK-bonus. It seems as if JAK-inhibitors exert some inflammation-independent effects on pain, fatigue and wellbeing, and that drug treatment of rheumatic diseases is more than the inhibition of inflammation alone.
AB - Biological- or targeted-synthetic DMARD-responses reported in randomized clinical trials, placebo-controlled or head-to-head, in patients with rheumatoid arthritis, psoriatic arthritis or spondyloarthritis are unbelievably similar, when looking across trials performed in the same disease and applying the same primary outcome measures. The exception to this rule may be the response to Janus-kinase-inhibitors, which seem to work 10 % better in all trials (JAK-bonus) This article provides a potential explanation for this remarkable phenomenon, including an explanation for the JAK-bonus. It seems as if JAK-inhibitors exert some inflammation-independent effects on pain, fatigue and wellbeing, and that drug treatment of rheumatic diseases is more than the inhibition of inflammation alone.
KW - Rheumatoid arthritis DMARDs JAK-inhibitors Randomized clinical trials Non-specific treatment effects
UR - http://www.scopus.com/inward/record.url?scp=85182548229&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.semarthrit.2023.152316
DO - https://doi.org/10.1016/j.semarthrit.2023.152316
M3 - Article
C2 - 38218699
SN - 0049-0172
VL - 64
JO - Seminars in Arthritis and Rheumatism
JF - Seminars in Arthritis and Rheumatism
M1 - 152316
ER -