{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T14:10:17Z","timestamp":1782569417489,"version":"3.54.5"},"reference-count":32,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T00:00:00Z","timestamp":1761782400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["ACR Open Rheumatology"],"published-print":{"date-parts":[[2025,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We performed a real\u2010world characterization of patients with rheumatoid arthritis (RA) who initiate a JAK inhibitor (JAKi) and switch to a subsequent therapy and examination of factors associated with the use of another JAKi\/therapy with another mechanism of action (MoA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study included patients with RA in the US CorEvitas RA Registry who initiated a JAKi (August 16, 2019, to October 30, 2023), had prior exposure to at least one conventional synthetic disease\u2010modifying antirheumatic drug (DMARD) and at least one biologic DMARD (bDMARD), and switched to another therapy within three months of JAKi discontinuation. Patients were classified as JAKi \u201ccyclers\u201d or \u201cswitchers\u201d from JAKi to another MoA. Outcomes evaluated from JAKi initiation to cycle\/switch included the Clinical Disease Activity Index (CDAI) score and patient\u2010reported outcomes. Factors associated with switching versus cycling were identified using multivariable logistic regression models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 197 patients were included: 27.9% were cyclers, and 72.1% were switchers; most had moderate\/high CDAI scores and received initial JAKi as a fourth or higher line of therapy. From JAKi initiation to switch, improvements in CDAI scores\/patient\u2010reported outcomes were numerically greater for cyclers versus switchers. History (present ever\/at enrollment) of hypertension was associated with higher odds, and history of fibromyalgia and prior use of two or more bDMARDs versus one bDMARD were associated with lower odds of switching versus cycling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this real\u2010world US study of patients with RA, compared with switching, cycling was observed in patients with better response to initial JAKi, a history of fibromyalgia, and prior use of two or more bDMARDs. Sample size, which was smaller in cyclers than in switchers, limited the study; larger studies are required to evaluate effectiveness.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/acr2.70109","type":"journal-article","created":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T07:22:27Z","timestamp":1761808947000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Characterization of Second\u2010Line Therapy After First\n                    <scp>JAK<\/scp>\n                    Inhibitor Use: Results From the\n                    <scp>CorEvitas<\/scp>\n                    Rheumatoid Arthritis Registry"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0799-7563","authenticated-orcid":false,"given":"Joshua F.","family":"Baker","sequence":"first","affiliation":[{"name":"University of Pennsylvania and Corporal Michael J. Crescenz VA Medical Center  Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5699-6797","authenticated-orcid":false,"given":"Kristi V.","family":"Mizelle","sequence":"additional","affiliation":[{"name":"Eastern Virginia Medical School, Norfolk, and Tidewater Physicians Multispecialty Group Rheumatology  Newport News Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7795-9429","authenticated-orcid":false,"given":"Wassim","family":"Saikali","sequence":"additional","affiliation":[{"name":"Rheumatology and Pulmonary Clinic  Beckley West Virginia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3428-8781","authenticated-orcid":false,"given":"Page C.","family":"Moore","sequence":"additional","affiliation":[{"name":"CorEvitas, LLC  Waltham Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6765-7603","authenticated-orcid":false,"given":"Hyung\u2010Joo","family":"Kang","sequence":"additional","affiliation":[{"name":"CorEvitas, LLC  Waltham Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3516-5289","authenticated-orcid":false,"given":"David","family":"Gruben","sequence":"additional","affiliation":[{"name":"Pfizer Inc  Groton Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1028-5866","authenticated-orcid":false,"given":"Ahmed","family":"Shelbaya","sequence":"additional","affiliation":[{"name":"Pfizer Inc  New York New York"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-2387-5209","authenticated-orcid":false,"given":"Lori","family":"Stockert","sequence":"additional","affiliation":[{"name":"Pfizer Inc  Collegeville Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-4998-5747","authenticated-orcid":false,"given":"Jacqueline","family":"O'Brien","sequence":"additional","affiliation":[{"name":"CorEvitas, LLC  Waltham Massachusetts"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,10,30]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2022-223356"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.24596"},{"key":"e_1_2_9_4_1","unstructured":"Xeljanz (tofacitinib).Highlights of prescribing information. Pfizer;2024.https:\/\/labeling.pfizer.com\/showlabeling.aspx?id=959"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61424-X"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.40803"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1109071"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-159-4-201308200-00006"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1112072"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1310476"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)31618-5"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-019-1866-2"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-016-0932-2"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31116-4"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)31115-2"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41384"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.41032"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2008250"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30419-2"},{"key":"e_1_2_9_20_1","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2023-003918"},{"key":"e_1_2_9_21_1","doi-asserted-by":"publisher","DOI":"10.1007\/s40744-024-00639-4"},{"key":"e_1_2_9_22_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.2023-0752"},{"issue":"9","key":"e_1_2_9_23_1","first-page":"1763","article-title":"Real\u2010world utilisation and switching between Janus kinase inhibitors in Australian patients with rheumatoid arthritis in the OPAL dataset","volume":"42","author":"Ciciriello S","year":"2024","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_9_24_1","doi-asserted-by":"publisher","DOI":"10.55563\/clinexprheumatol\/cbanza"},{"key":"e_1_2_9_25_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/keac285"},{"key":"e_1_2_9_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard-2022-222835"},{"key":"e_1_2_9_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22606"},{"key":"e_1_2_9_28_1","unstructured":"RINVOQ(upadacitinib).Highlights of prescribing information. AbbVie;2024.https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2024\/211675s021s022lbl.pdf"},{"key":"e_1_2_9_29_1","unstructured":"OLUMIANT(baricitinib).Highlights of prescribing information. Eli Lilly and Company;2022.https:\/\/www.accessdata.fda.gov\/drugsatfda_docs\/label\/2022\/207924s007lbl.pdf"},{"key":"e_1_2_9_30_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2019-215764"},{"key":"e_1_2_9_31_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa2109927"},{"key":"e_1_2_9_32_1","volume-title":"FDA requires warnings about increased risk of serious heart\u2010related events, cancer, blood clots, and death for JAK inhibitors that treat certain chronic inflammatory conditions","author":"US Food and Drug Administration","year":"2021"},{"key":"e_1_2_9_33_1","doi-asserted-by":"publisher","DOI":"10.3390\/nu12010202"}],"container-title":["ACR Open Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/acr2.70109","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,26]],"date-time":"2025-11-26T06:02:10Z","timestamp":1764136930000},"score":1,"resource":{"primary":{"URL":"https:\/\/acrjournals.onlinelibrary.wiley.com\/doi\/10.1002\/acr2.70109"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10,30]]},"references-count":32,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2025,11]]}},"alternative-id":["10.1002\/acr2.70109"],"URL":"https:\/\/doi.org\/10.1002\/acr2.70109","archive":["Portico"],"relation":{},"ISSN":["2578-5745","2578-5745"],"issn-type":[{"value":"2578-5745","type":"print"},{"value":"2578-5745","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10,30]]},"assertion":[{"value":"2025-04-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-07-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-30","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70109"}}