{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T10:09:41Z","timestamp":1781258981612,"version":"3.54.1"},"reference-count":26,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2023,7,10]],"date-time":"2023-07-10T00:00:00Z","timestamp":1688947200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: We examined the real-world drug retention rate and safety data of Janus kinase inhibitors (JAKis) in elderly patients with rheumatoid arthritis (RA). Methods: This study enrolled 133 RA patients (\u226565 years) with sufficient clinical data who were initiated with JAKis during the study period. These patients were divided into two groups: the very elderly group (\u2265\u200975 years) and the elderly group (65 \u2264 years &lt; 75). The drug retention rates of JAKis were compared using Kaplan\u2013Meier curves. Results: The discontinuation rates of JAKis were as follows: lack of effectiveness 27 (20.3%), adverse events (AEs) 29 (21.8%), and remission 2 (1.5%). There was no significant difference in the overall drug retention rate between the very elderly group (\u226575 years) and the elderly group. Furthermore, the overall drug retention rates of JAKis were not affected by gender, methotrexate use, and anti-citrullinated protein\/peptide antibody (ACPA) status. The discontinuation rates of JAKis due to AEs were comparable both in the very elderly group (\u226575 years) and the elderly group (65 \u2264 years &lt; 75). Whereas chronic lung disease and hypoalbuminemia were independently associated with discontinuation rates due to AEs, the overall drug retention rates were significantly lower in patients treated with the approved dose of JAKis than in those treated with a reduced or tapered dose. Conclusions: Our results suggest that the overall drug retention rate of JAKis in very elderly patients (\u226575 years) was comparable with that in elderly patients (65 \u2264 years &lt; 75). The discontinuation rates of JAKis due to AEs were also comparable both in very elderly group patients and elderly patients.<\/jats:p>","DOI":"10.3390\/jcm12144585","type":"journal-article","created":{"date-parts":[[2023,7,11]],"date-time":"2023-07-11T01:58:14Z","timestamp":1689040694000},"page":"4585","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["Drug Retention Rates and the Safety of Janus Kinase Inhibitors in Elderly Patients with Rheumatoid Arthritis"],"prefix":"10.3390","volume":"12","author":[{"given":"Jumpei","family":"Temmoku","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayuki","family":"Miyata","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Jananese Red Cross Fukushima Hospital, Yashima 7-7, Fukushima 963-8558, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eiji","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Ohta-Nishinouchi Hospital, 2-5-20 Nishinouchi, Koriyama 963-8558, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuya","family":"Sumichika","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Saito","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5123-3136","authenticated-orcid":false,"given":"Shuhei","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haruki","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3936-3007","authenticated-orcid":false,"given":"Yuya","family":"Fujita","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoki","family":"Matsuoka","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyuki","family":"Asano","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8110-8261","authenticated-orcid":false,"given":"Shuzo","family":"Sato","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiyoshi","family":"Migita","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Fukushima Medical University School of Medicine, 1 Hikarigaoka, Fukushima 960-1295, Fukushima, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,7,10]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1038\/ni.3691","article-title":"Mechanisms and consequences of Jak-STAT signaling in the immune system","volume":"18","author":"Villarino","year":"2017","journal-title":"Nat. Immunol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"78","DOI":"10.1038\/nrd.2017.267","article-title":"JAK inhibition as a therapeutic strategy for immune and inflammatory diseases","volume":"17","author":"Schwartz","year":"2017","journal-title":"Nat. Rev. Drug Discov."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1038\/s41584-021-00726-8","article-title":"Janus kinase-targeting therapies in rheumatology: A mechanisms-based approach","volume":"18","author":"Tanaka","year":"2022","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1759720x21999564","DOI":"10.1177\/1759720X21999564","article-title":"Comparative efficacy and safety of Janus kinase inhibitors and biological disease-modifying antirheumatic drugs in rheumatoid arthritis: A systematic review and network meta-analysis","volume":"13","author":"Weng","year":"2021","journal-title":"Ther. Adv. Musculoskelet. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"102528","DOI":"10.1016\/j.autrev.2020.102528","article-title":"Rheumatoid arthritis in the elderly: Characteristics and treatment considerations","volume":"19","author":"Serhal","year":"2020","journal-title":"Autoimmun. Rev."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"977265","DOI":"10.3389\/fimmu.2022.977265","article-title":"Comparative efficacy and safety of JAK inhibitors as monotherapy and in combination with methotrexate in patients with active rheumatoid arthritis: A systematic review and meta-analysis","volume":"13","author":"Liu","year":"2022","journal-title":"Front. Immunol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1007\/s40266-022-00976-5","article-title":"Difficult-to-Treat Rheumatoid Arthritis in Older Adults: Implications of Ageing for Managing Patients","volume":"39","author":"Balsa","year":"2022","journal-title":"Drugs Aging"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1080\/1744666X.2022.2014323","article-title":"The infection risks of JAK inhibition","volume":"18","author":"Adas","year":"2022","journal-title":"Expert. Rev. Clin. Immunol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e002236","DOI":"10.1136\/rmdopen-2022-002236","article-title":"Waiting for JAK inhibitor safety data","volume":"8","author":"Kragstrup","year":"2022","journal-title":"RMD Open"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1136\/ard-2022-223356","article-title":"EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update","volume":"82","author":"Smolen","year":"2023","journal-title":"Ann. Rheum. Dis."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2569","DOI":"10.1002\/art.27584","article-title":"2010 Rheumatoid arthritis classification criteria: An American College of Rheumatology\/European League Against Rheumatism collaborative initiative","volume":"62","author":"Aletaha","year":"2010","journal-title":"Arthritis Rheum."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1038\/s41598-021-04075-0","article-title":"Factors affecting drug retention of Janus kinase inhibitors in patients with rheumatoid arthritis: The ANSWER cohort study","volume":"12","author":"Ebina","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"720","DOI":"10.1002\/art.39988","article-title":"Different Rating of Global Rheumatoid Arthritis Disease Activity in Rheumatoid Arthritis Patients with Multiple Morbidities","volume":"69","author":"Radner","year":"2017","journal-title":"Arthritis Rheumatol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1093\/mr\/roab087","article-title":"Treatment strategies for elderly-onset rheumatoid arthritis in the new era","volume":"32","author":"Sugihara","year":"2022","journal-title":"Mod. Rheumatol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e000546","DOI":"10.1136\/rmdopen-2017-000546","article-title":"Safety and efficacy of baricitinib in elderly patients with rheumatoid arthritis","volume":"3","author":"Fleischmann","year":"2017","journal-title":"RMD Open"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1249","DOI":"10.1002\/acr.23769","article-title":"Risk for Herpes Zoster in Tofacitinib-Treated Rheumatoid Arthritis Patients With and Without Concomitant Methotrexate and Glucocorticoids","volume":"71","author":"Curtis","year":"2019","journal-title":"Arthritis Care Res."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1136\/annrheumdis-2015-207942","article-title":"Impact of baseline anti-cyclic citrullinated peptide-2 antibody concentration on efficacy outcomes following treatment with subcutaneous abatacept or adalimumab: 2-year results from the AMPLE trial","volume":"75","author":"Sokolove","year":"2016","journal-title":"Ann. Rheum. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"723","DOI":"10.2165\/00002512-200320100-00002","article-title":"Methotrexate intolerance in elderly patients with rheumatoid arthritis: What are the alternatives?","volume":"20","author":"Drosos","year":"2003","journal-title":"Drugs Aging"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1056\/NEJMoa1109071","article-title":"Placebo-controlled trial of tofacitinib monotherapy in rheumatoid arthritis","volume":"367","author":"Fleischmann","year":"2012","journal-title":"N. Engl. J. Med."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"457","DOI":"10.1016\/S0140-6736(17)31618-5","article-title":"Efficacy and safety of tofacitinib monotherapy, tofacitinib with methotrexate, and adalimumab with methotrexate in patients with rheumatoid arthritis (ORAL Strategy): A phase 3b\/4, double-blind, head-to-head, randomised controlled trial","volume":"390","author":"Fleischmann","year":"2017","journal-title":"Lancet"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"2303","DOI":"10.1016\/S0140-6736(19)30419-2","article-title":"Upadacitinib as monotherapy in patients with active rheumatoid arthritis and inadequate response to methotrexate (SELECT-MONOTHERAPY): A randomised, placebo-controlled, double-blind phase 3 study","volume":"393","author":"Smolen","year":"2019","journal-title":"Lancet"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1136\/annrheumdis-2018-213271","article-title":"Dose reduction of baricitinib in patients with rheumatoid arthritis achieving sustained disease control: Results of a prospective study","volume":"78","author":"Takeuchi","year":"2019","journal-title":"Ann. Rheum. Dis."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1093\/mr\/roac017","article-title":"Drug Treatment Algorithm and Recommendations from the 2020 update of the Japan College of Rheumatology Clinical Practice Guidelines for the Management of Rheumatoid Arthritis-Secondary Publication","volume":"33","author":"Kawahito","year":"2022","journal-title":"Mod. Rheumatol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"316","DOI":"10.1056\/NEJMoa2109927","article-title":"Cardiovascular and Cancer Risk with Tofacitinib in Rheumatoid Arthritis","volume":"386","author":"Ytterberg","year":"2022","journal-title":"N. Engl. J. Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1097\/RHU.0000000000001804","article-title":"Risk of Cardiovascular and Venous Thromboembolic Events Associated With Janus Kinase Inhibitors in Rheumatoid Arthritis: A Systematic Review and Network Meta-analysis","volume":"28","author":"Alves","year":"2022","journal-title":"J. Clin. Rheumatol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1136\/annrheumdis-2018-214846","article-title":"Impact of Janus kinase inhibitors on risk of cardiovascular events in patients with rheumatoid arthritis: Systematic review and meta-analysis of randomised controlled trials","volume":"78","author":"Xie","year":"2019","journal-title":"Ann. Rheum. Dis."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/14\/4585\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T20:09:51Z","timestamp":1760126991000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/12\/14\/4585"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,7,10]]},"references-count":26,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2023,7]]}},"alternative-id":["jcm12144585"],"URL":"https:\/\/doi.org\/10.3390\/jcm12144585","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,7,10]]}}}