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In clinical trials, the Janus kinase inhibitors (JAKis) have demonstrated good efficacy in pain relief. Aim of our study was to evaluate the real-life effectiveness of JAKis in improving pain in patients with RA in different states of baseline disease activity. A monocentric prospective cohort of 181 RA patients starting treatment with JAKis was studied. Pain was evaluated on a 0\u2013100\u00a0mm visual analogue scale (VAS). Clinically meaningful improvements over 24\u00a0weeks were defined as follows: proportion of patients achieving\u2009\u2265\u200930%,\u2009\u2265\u200950%, and\u2009\u2265\u200970% pain relief, and remaining pain\u2009\u2264\u200920 or\u2009\u2264\u200910\u00a0mm. Results were analysed after stratification for baseline inflammatory activity; patients with swollen joints and C-reactive protein\u2009\u2264\u20091 at treatment start were considered pauci-inflammatory. Proportion of patients who achieved\u2009\u2265\u200930%,\u2009\u2265\u200950% and\u2009\u2265\u200970% pain improvement at 24\u00a0weeks was 61.4%, 49.3% and 32.9%. Furthermore, 40.6% and 28.5% of the patients achieved thresholds of remaining pain equivalent to mild pain or no\/limited pain. Pain improvements were more evident in patients naive to previous biologics, although nearly 30% of multiple failures achieved VAS\u2009\u2264\u200920\u00a0mm. No significant differences were observed in relation to monotherapy. Pauci-inflammatory patients at treatment start achieved good outcomes, with 40.4% experiencing\u2009\u2265\u200970% pain improvement, and 35.7% VAS\u2009\u2264\u200910\u00a0mm. JAKis show efficacy in pain relief in real life. The improvement of painful symptoms also in those patients with limited objective inflammation may open new perspectives on the management of difficult-to-treat RA.<\/jats:p>","DOI":"10.1007\/s11739-023-03350-4","type":"journal-article","created":{"date-parts":[[2023,7,27]],"date-time":"2023-07-27T17:02:21Z","timestamp":1690477341000},"page":"1733-1740","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Janus kinase inhibitors effectively improve pain across different disease activity states in rheumatoid arthritis"],"prefix":"10.1007","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2312-2161","authenticated-orcid":false,"given":"Ludovico","family":"De Stefano","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emanuele","family":"Bozzalla Cassione","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Bottazzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Marazzi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Maggiore","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Morandi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlomaurizio","family":"Montecucco","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serena","family":"Bugatti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,7,27]]},"reference":[{"key":"3350_CR1","doi-asserted-by":"publisher","first-page":"18001","DOI":"10.1038\/nrdp.2018.1","volume":"4","author":"JS Smolen","year":"2018","unstructured":"Smolen JS, Aletaha D, Barton A, Burmester GR, Emery P, Firestein GS et al (2018) Rheumatoid arthritis. 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CM reports personal fees from: AbbVie, Amgen, Bristol-Myers Squibb, Eli Lilly, Galapagos, Novartis, Pfizer, Roche. SB reports grant\/research support from: Pfizer, and personal fees from: AbbVie, Amgen, Bristol-Myers Squibb, Eli Lilly, Galapagos, Novartis, Pfizer.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"Fondazione IRCCS Policlinico San Matteo Ethics Committee n.20210092818.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Patients and\/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Patient and public involvement"}},{"value":"All participants provided informed consent prior to their participation.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}}]}}