2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/2iy5wruuedsh6.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/00yc7rcvua6a7.js","/_next/static/immutable/chunks/37ktb71aq3480.js","/_next/static/immutable/chunks/2d50b-7eu4558.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/2d6noqpp6ehas.js","/_next/static/immutable/chunks/1sx186c93bpzg.js","/_next/static/immutable/chunks/3dc-1n866s65i.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2w1bvggzb0ga8.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T462,The treatment of anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis with interstitial lung disease (MDA5 This multi-centre cohort study in China enrolled MDA5 In the eligible cohort, a total of 106 patients were treated with UPA and 328 with TOFA. The crude 6-month lung transplantation-free survival rates were 71.7% (76/106) in the UPA group and 67.4% (221/328) in the TOFA group. In the IPTW-adjusted cohort, UPA showed a trend toward higher survival than TOFA (p = 0.067), with a weighted risk difference of 10.3% (95% confidence interval -0.4% to 20.2%) meeting the non-inferiority margin (non-inferiority p = 0.003). Sensitivity and subgroup analyses showed consistent results, with potentially greater benefit of UPA in incident JAK inhibitor users (as first-line treatment), monotherapy recipients (without combination with other immunosuppressants except steroid), and those with rapidly progressive ILD. Safety profiles were comparable between groups. UPA was found to be non-inferior to TOFA in improving 6-month lung transplantation-free survival among patients with MDA531:Tb4a,ABSTRACT Background and Objective The treatment of anti‐melanoma differentiation‐associated gene 5 antibody‐positive dermatomyositis with interstitial lung disease (MDA5 + DM‐ILD) remains a significant clinical challenge. To compare the effectiveness and safety of upadacitinib (UPA) versus tofacitinib (TOFA) upon 6‐month lung transplantation‐free survival in newly diagnosed MDA5 + DM‐ILD patients. Methods This multi‐centre cohort study in China enrolled MDA5 + DM‐ILD patients treated from January 2020 to February 2025. Prevalent/incident new users and non‐inferior design along with inverse probability treatment weighting (IPTW) were implemented to emulate randomized controlled trial. Results In the eligible cohort, a total of 106 patients were treated with UPA and 328 with TOFA. The crude 6‐month lung transplantation‐free survival rates were 71.7% (76/106) in the UPA group and 67.4% (221/328) in the TOFA group. In the IPTW‐adjusted cohort, UPA showed a trend toward higher survival than TOFA ( p = 0.067), with a weighted risk difference of 10.3% (95% confidence interval −0.4% to 20.2%) meeting the non‐inferiority margin (non‐inferiority p = 0.003). Sensitivity and subgroup analyses showed consistent results, with potentially greater benefit of UPA in incident JAK inhibitor users (as first‐line treatment), monotherapy recipients (without combination with other immunosuppressants except steroid), and those with rapidly progressive ILD. Safety profiles were comparable between groups. Conclusion UPA was found to be non‐inferior to TOFA in improving 6‐month lung transplantation‐free survival among patients with MDA5 + DM‐ILD, with comparable safety. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Xeljanz: brand Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Xeljanz (brand). Clinician-written summaries and actionable practice insights. 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Results Of A Phase II Investigator-Initiated Study.","journal_title":"Respiratory Medicine","journal_issn":"0954-6111","published_at":"2026-09-10T00:00:00.000Z","url":"https://doi.org/10.1016/j.rmed.2026.109150","source_score":4,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-16T06:22:49.834Z","updated_at":"2026-09-16T06:22:49.834Z","tags":[{"paper_doi":"10.1016/j.rmed.2026.109150","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109150","tag_type":"brand","value":"Ofev","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109150","tag_type":"brand","value":"Xeljanz","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109150","tag_type":"category","value":"Respiratory System","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109150","tag_type":"condition","value":"Progressive Pulmonary Fibrosis","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109150","tag_type":"condition","value":"Rheumatoid Arthritis-Associated Interstitial Lung Disease","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109150","tag_type":"generic","value":"nintedanib","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109150","tag_type":"generic","value":"tofacitinib","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109150","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109150","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109150","tag_type":"modality","value":"Antifibrotic Agent","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109150","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109150","tag_type":"sample_size","value":"n=39","value_numeric":39},{"paper_doi":"10.1016/j.rmed.2026.109150","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109150","tag_type":"study_design","value":"Phase II Non-Randomized Interventional Trial","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109150","tag_type":"warning","value":"KL-6 units appear inconsistently reported in the abstract (mU/mL at baseline, mU/L for the decline) — this likely reflects a transcription error in the source text.","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109150","tag_type":"warning","value":"Nine patients received concomitant nintedanib, which may confound both safety and biomarker outcomes despite subgroup analysis.","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109150","tag_type":"warning","value":"No control/placebo arm was included; efficacy conclusions (FVC decline, KL-6 reduction) are descriptive only and cannot establish causation.","value_numeric":null},{"paper_doi":"10.1016/j.rmed.2026.109150","tag_type":"warning","value":"Study design is described as Phase II investigator-initiated without randomization — closest label is a single-arm interventional trial; study design tag reflects this.","value_numeric":null}],"summaries":{"what_studied":"This Phase II investigator-initiated trial evaluated the safety and efficacy of tofacitinib 5 mg BID over 48 weeks in 39 patients with rheumatoid arthritis-associated interstitial lung disease (RA-ILD), with KL-6 as a serum biomarker of lung disease activity.","key_result":"92% of patients experienced at least one adverse event (most commonly upper airway infections); 3 patients died; 15 patients (38.5/100 patient-years) met the combined endpoint of mortality and/or progressive pulmonary fibrosis (PPF). FVC declined by a mean of -72 mL at 48 weeks. KL-6 fell from a baseline LSM of 34,358 mU/mL to 32,191 mU/mL (LSM decline of -2,167 mU/mL). At 48 weeks, 51% of patients achieved low disease activity by SDAI.","limitations":"- Small sample (n=39) limits power to detect efficacy signals beyond biomarker trends.\n- No control arm; observed changes in FVC and KL-6 cannot be attributed solely to tofacitinib.\n- Nine patients also received nintedanib during the trial, introducing potential confounding despite subgroup analysis.","practice_takeaway":"Tofacitinib carries a high adverse-event burden in RA-ILD (92%), and nearly 40% of patients still progressed or died at 48 weeks — clinicians should weigh this risk carefully. The decline in KL-6 levels may support its use as a monitoring biomarker in this population, but efficacy conclusions require confirmation in a controlled trial."}},{"doi":"10.1016/j.cgh.2026.07.020","pmid":"42562116","title":"Superior Effectiveness of Upadacitinib Over Tofacitinib and Ustekinumab in Bio-Exposed Ulcerative Colitis: The TRIDENT-UC Study","journal_title":"Clinical Gastroenterology and Hepatology","journal_issn":"1542-3565","published_at":"2026-08-07T00:00:00.000Z","url":"https://doi.org/10.1016/j.cgh.2026.07.020","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-14T13:24:53.592Z","updated_at":"2026-08-14T13:24:53.592Z","tags":[{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"brand","value":"Rinvoq","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"brand","value":"Stelara","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"brand","value":"Xeljanz","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"condition","value":"Ulcerative Colitis","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"generic","value":"tofacitinib","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"generic","value":"upadacitinib","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"generic","value":"ustekinumab","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"modality","value":"IL-12/23 Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"sample_size","value":"n=312","value_numeric":312},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"warning","value":"The mean age at diagnosis (32.6 years) is reported, but the age range of enrolled patients is not provided, limiting age-group precision beyond 'adult'.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously — this is a retrospective observational study with IPTW adjustment, not a head-to-head RCT; residual confounding cannot be excluded.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"warning","value":"Tofacitinib subgroup (n=74) is notably smaller than ustekinumab (n=135) and upadacitinib (n=103), which may affect the stability of IPTW-weighted estimates for that arm.","value_numeric":null},{"paper_doi":"10.1016/j.cgh.2026.07.020","tag_type":"warning","value":"Ustekinumab is not FDA-approved specifically for UC in the same manner as for Crohn's disease; its use in this context may reflect off-label or region-specific prescribing practices.","value_numeric":null}],"summaries":{"what_studied":"Retrospective multicenter study (9 centers, n=312) comparing upadacitinib, tofacitinib, and ustekinumab in bio-exposed UC patients who had failed ≥1 advanced therapy, assessed at weeks 16 and 52 for steroid-free clinical remission (SFCR) and endoscopic remission.","key_result":"After propensity score-weighted analysis, upadacitinib had higher SFCR odds vs. tofacitinib (w16: OR 2.56; w52: OR 3.14) and ustekinumab (w16: OR 3.71; w52: OR 4.68). Endoscopic remission rates at w52 were 56.8% (upadacitinib) vs. 32.7% (tofacitinib) vs. 22.5% (ustekinumab), with upadacitinib outperforming both at both timepoints.","limitations":"Retrospective design with inherent selection bias; IPTW mitigates but does not eliminate confounding; single-country or limited-center generalizability not specified, and small subgroup sizes (tofacitinib n=74) may limit precision of estimates.","practice_takeaway":"In UC patients who have failed a prior biologic, upadacitinib achieves meaningfully higher rates of steroid-free clinical and endoscopic remission than either tofacitinib or ustekinumab at both 16 and 52 weeks. Clinicians should prioritize upadacitinib when selecting a second-line advanced therapy in this population."}},{"doi":"10.1002/art.70284","pmid":"42549483","title":"Age‐associated B cells contribute to inflammation via antibody‐independent mechanisms in Takayasu's arteritis","journal_title":"Arthritis & Rheumatology","journal_issn":"2326-5191","published_at":"2026-08-04T00:00:00.000Z","url":"https://doi.org/10.1002/art.70284","source_score":10,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-12T13:26:10.916Z","updated_at":"2026-08-12T13:26:10.916Z","tags":[{"paper_doi":"10.1002/art.70284","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1002/art.70284","tag_type":"brand","value":"Humira","value_numeric":null},{"paper_doi":"10.1002/art.70284","tag_type":"brand","value":"Xeljanz","value_numeric":null},{"paper_doi":"10.1002/art.70284","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1002/art.70284","tag_type":"condition","value":"Systemic Lupus Erythematosus","value_numeric":null},{"paper_doi":"10.1002/art.70284","tag_type":"condition","value":"Takayasu's Arteritis","value_numeric":null},{"paper_doi":"10.1002/art.70284","tag_type":"generic","value":"adalimumab","value_numeric":null},{"paper_doi":"10.1002/art.70284","tag_type":"generic","value":"tofacitinib","value_numeric":null},{"paper_doi":"10.1002/art.70284","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1002/art.70284","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1002/art.70284","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1002/art.70284","tag_type":"modality","value":"TNF Inhibitor","value_numeric":null},{"paper_doi":"10.1002/art.70284","tag_type":"sample_size","value":"n=125","value_numeric":125},{"paper_doi":"10.1002/art.70284","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1002/art.70284","tag_type":"study_design","value":"Translational/Mechanistic Study","value_numeric":null},{"paper_doi":"10.1002/art.70284","tag_type":"warning","value":"Study design is labeled 'Translational/Mechanistic Study' as the paper combines histology, multi-omics, and a small clinical follow-up without a formal RCT structure; level of evidence set to 4 accordingly.","value_numeric":null},{"paper_doi":"10.1002/art.70284","tag_type":"warning","value":"The largest flow cytometry cohort (n=125) likely includes heterogeneous subgroups across different experimental aims; individual experiment sizes (n=4 to n=15) are much smaller and should be interpreted cautiously.","value_numeric":null},{"paper_doi":"10.1002/art.70284","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously — findings are mechanistic and the clinical comparator arm (n=4) is exploratory only; prospective RCT data are lacking.","value_numeric":null}],"summaries":{"limitations":"The exploratory clinical cohort comparing tofacitinib to adalimumab was very small (n=4), limiting generalizability. The study is largely mechanistic and observational, without a randomized comparator arm. Histological analysis was restricted to 5 patients.","what_studied":"This study investigated the role of age-associated B cells (ABCs) in Takayasu's arteritis (TAK) pathogenesis — including their activation pathway, proinflammatory functions, and response to tofacitinib vs. adalimumab — using histology, bulk RNA-seq, scRNA-seq, flow cytometry, and in vitro experiments, with a small exploratory clinical follow-up (n=4).","key_result":"ABCs in TAK drive inflammation via proinflammatory cytokine production and Th17 promotion, largely independent of antibody-secreting cell differentiation — a pattern distinct from SLE. In vitro, tofacitinib reduced ABC proportions and attenuated their proinflammatory phenotype more effectively than adalimumab (n=15), with consistent trends in 4 clinical cases.","practice_takeaway":"In TAK, B cells appear to promote inflammation through antibody-independent mechanisms, suggesting that standard anti-TNF therapy may be insufficient to fully suppress this pathway. JAK inhibition with tofacitinib shows early promise in targeting ABCs, warranting prospective trials in TAK."}},{"doi":"10.1016/s2665-9913(26)00151-7","pmid":"42546722","title":"Impact of BMI on response to Janus kinase inhibitors in rheumatoid arthritis: an individual patient data meta-analysis of randomised controlled trials","journal_title":"The Lancet Rheumatology","journal_issn":"2665-9913","published_at":"2026-08-03T00:00:00.000Z","url":"https://doi.org/10.1016/s2665-9913(26)00151-7","source_score":10,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-13T13:22:57.879Z","updated_at":"2026-08-13T13:22:57.879Z","tags":[{"paper_doi":"10.1016/s2665-9913(26)00151-7","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00151-7","tag_type":"brand","value":"Olumiant","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00151-7","tag_type":"brand","value":"Rinvoq","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00151-7","tag_type":"brand","value":"Xeljanz","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00151-7","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00151-7","tag_type":"condition","value":"Obesity","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00151-7","tag_type":"condition","value":"Rheumatoid Arthritis","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00151-7","tag_type":"generic","value":"baricitinib","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00151-7","tag_type":"generic","value":"tofacitinib","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00151-7","tag_type":"generic","value":"upadacitinib","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00151-7","tag_type":"impact_flag","value":"practice_changing","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00151-7","tag_type":"level_of_evidence","value":"1","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00151-7","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00151-7","tag_type":"sample_size","value":"n=11883","value_numeric":11883},{"paper_doi":"10.1016/s2665-9913(26)00151-7","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00151-7","tag_type":"study_design","value":"Individual Patient Data Meta-Analysis of Randomised Controlled Trials","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00151-7","tag_type":"warning","value":"Between-study heterogeneity was low to moderate (I²=0–40%); results are robust but some variability across trials remains.","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00151-7","tag_type":"warning","value":"Filgotinib was excluded due to missing variables, so findings may not generalize to all JAK inhibitors.","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00151-7","tag_type":"warning","value":"The PROSPERO registration number contains a likely typographical error ('CRD420251180005') — may be worth verifying the correct ID.","value_numeric":null},{"paper_doi":"10.1016/s2665-9913(26)00151-7","tag_type":"warning","value":"The study population was 80.7% women and 71.5% White, which may limit generalizability to more diverse or male-predominant populations.","value_numeric":null}],"summaries":{"what_studied":"This individual patient data (IPD) meta-analysis of 16 phase 3 RCTs evaluated whether BMI modifies the clinical response to JAK inhibitors (tofacitinib, baricitinib, upadacitinib) in 11,883 adult RA patients, using ACR20 response and DAS28-CRP as primary outcomes at each trial's primary efficacy timepoint.","key_result":"Higher BMI was independently associated with worse JAK inhibitor response in a dose-dependent gradient: vs. healthy weight, adjusted RR for ACR20 was 0.94 for overweight, 0.92 for class 1 obesity, 0.88 for class 2, and 0.78 for class 3 obesity (≥40 kg/m²); DAS28-CRP differences were +0.14, +0.21, +0.30, and +0.54 respectively. No BMI gradient was seen in the placebo group, confirming obesity as an effect modifier.","limitations":"Filgotinib trials were excluded due to insufficient variables, limiting generalizability across all JAK inhibitors. The analysis is restricted to trial populations, which may not fully represent real-world RA patients with severe obesity. No involvement of patients with lived experience in study design.","practice_takeaway":"Clinicians should anticipate meaningfully reduced JAK inhibitor efficacy in RA patients with obesity, especially class 3 (BMI ≥40 kg/m²), and actively integrate weight management into treatment planning. Consider this BMI-response gradient when selecting therapy or setting treatment expectations in patients with higher BMI."}},{"doi":"10.1093/ibd/izag142","pmid":"42520305","title":"Risk of serious infection, myocardial infarction, stroke, and thromboembolic events in patients in the United States with ulcerative colitis treated with tofacitinib compared with biologic treatments","journal_title":"Inflammatory Bowel Diseases","journal_issn":"1078-0998","published_at":"2026-07-28T00:00:00.000Z","url":"https://doi.org/10.1093/ibd/izag142","source_score":7,"is_retracted":false,"is_open_access":false,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-08-04T18:18:01.291Z","updated_at":"2026-08-04T18:18:01.291Z","tags":[{"paper_doi":"10.1093/ibd/izag142","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"brand","value":"Entyvio","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"brand","value":"Stelara","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"brand","value":"Xeljanz","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"category","value":"Gastroenterology & Hepatology","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"condition","value":"Ulcerative Colitis","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"generic","value":"tofacitinib","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"generic","value":"ustekinumab","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"generic","value":"vedolizumab","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"modality","value":"IL-12/23 Inhibitor","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"modality","value":"Integrin Inhibitor","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"modality","value":"TNF Inhibitor","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"sample_size","value":"n=62596","value_numeric":62596},{"paper_doi":"10.1093/ibd/izag142","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"warning","value":"Sample size is the sum of all four treatment groups (5171 + 10424 + 17129 + 29872 = 62596); individual group Ns vary considerably, which may affect power for rare outcomes like MI/stroke.","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"warning","value":"TNF inhibitor brand names were not individually specified in the abstract; no brand tags were added for this class.","value_numeric":null},{"paper_doi":"10.1093/ibd/izag142","tag_type":"warning","value":"Tofacitinib initiators were markedly more biologic-experienced than biologic initiators at baseline; sIPTW adjustment was applied but residual confounding by indication is likely. Interpret hazard ratios with caution.","value_numeric":null}],"summaries":{"what_studied":"This retrospective cohort study used US claims data (Komodo Health) to compare risks of serious infection, MI, stroke, and VTE among UC patients initiating tofacitinib, ustekinumab, vedolizumab, or TNF inhibitors between May 2018 and September 2022, with a mean follow-up of ~359 days.","key_result":"No significant risk differences were found between tofacitinib and any biologic. Serious infection IRs/100 PY were 2.62 (tofacitinib), 2.73 (ustekinumab), 2.45 (vedolizumab), and 3.25 (TNFi). MI/stroke IRs/100 PY were 0.13, 0.17, 0.17, and 0.19; VTE IRs/100 PY were 0.17, 0.16, 0.23, and 0.33, respectively.","limitations":"- Tofacitinib initiators were more biologic-experienced at baseline (46.3% had ≥2 prior biologics vs 7.5%–33.7% for biologics), indicating channeling bias that sIPTW adjustment may not fully correct.\n- Mean follow-up of ~359 days may miss long-term safety signals.\n- Claims data cannot capture unmeasured confounders (e.g., disease severity, smoking status).","practice_takeaway":"In a large US real-world population with UC, tofacitinib showed no significantly higher risk of serious infection, MI, stroke, or VTE compared with ustekinumab, vedolizumab, or TNF inhibitors. Clinicians can factor these data into shared decision-making, particularly for biologic-experienced patients weighing tofacitinib."}},{"doi":"10.2340/actadv.v106.adv-2026-0453","pmid":"42377046","title":"Treatment Response to JAK Inhibitors in Long-standing Alopecia Areata (≥8 Years): A Real-world Observational Study","journal_title":"Acta Dermato-Venereologica","journal_issn":"1651-2057","published_at":"2026-06-30T00:00:00.000Z","url":"https://doi.org/10.2340/actadv.v106.adv-2026-0453","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-07-06T13:36:21.531Z","updated_at":"2026-07-06T13:36:21.531Z","tags":[{"paper_doi":"10.2340/actadv.v106.adv-2026-0453","tag_type":"age_group","value":"mixed","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0453","tag_type":"brand","value":"Litfulo","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0453","tag_type":"brand","value":"Olumiant","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0453","tag_type":"brand","value":"Xeljanz","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0453","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0453","tag_type":"condition","value":"Alopecia Areata","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0453","tag_type":"generic","value":"baricitinib","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0453","tag_type":"generic","value":"ritlecitinib","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0453","tag_type":"generic","value":"tofacitinib","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0453","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0453","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0453","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0453","tag_type":"sample_size","value":"n=31","value_numeric":31},{"paper_doi":"10.2340/actadv.v106.adv-2026-0453","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0453","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0453","tag_type":"warning","value":"Brand name for baricitinib listed as Olumiant and tofacitinib as Xeljanz; these are not explicitly stated in the paper — inferred from standard pharmacological knowledge.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0453","tag_type":"warning","value":"The baricitinib subgroup had only 4 patients with a disproportionately severe disease profile (mean duration 16.3 years, 75% ophiasis), making drug-specific efficacy comparisons unreliable and potentially confounded by case mix rather than drug potency alone.","value_numeric":null},{"paper_doi":"10.2340/actadv.v106.adv-2026-0453","tag_type":"warning","value":"The study includes adolescents (≥12 years, 35.5% of cohort) alongside adults, so age-group is 'mixed'; subgroup outcomes by age are not separately reported.","value_numeric":null}],"summaries":{"what_studied":"This retrospective, single-centre study evaluated the efficacy and safety of baricitinib, tofacitinib, or ritlecitinib in 31 patients with long-standing alopecia areata (current episode ≥8 years; mean duration 12.7 years) treated between February 2021 and December 2025, assessed at 12-week intervals up to week 36+.","key_result":"At week 24 (n=29), 48.3% achieved ≥30% SALT improvement (SALT30), 31.0% achieved SALT50, and 24.1% achieved SALT80; only 27.6% reached absolute SALT ≤20. Ritlecitinib was the most effective agent (71.4% SALT30 at last observation), while none of the 4 baricitinib-treated patients achieved any meaningful response. Treatment was discontinued in 58.1% (18/31), mainly due to lack of efficacy (66.7% of discontinuations). Most common adverse events were folliculitis (22.6%) and acne (12.9%); no serious adverse events occurred.","limitations":"- Small sample size (n=31) limits statistical power to detect predictors of response.\n- Retrospective, single-centre design with variable and relatively short follow-up and no control group.\n- Treatment adherence and concomitant therapies were not fully standardized or rigorously recorded.","practice_takeaway":"JAK inhibitors can still produce clinically meaningful hair regrowth in some patients with alopecia areata lasting ≥8 years, so they remain a viable option even in this hard-to-treat group. However, high discontinuation rates (58%) driven by lack of efficacy mean that patient expectations should be carefully managed, and ultra-long disease duration (>12 years) with refractory subtypes appears to predict poorer outcomes."}},{"doi":"10.1007/s10067-026-08175-y","pmid":"42240789","title":"Real-world efficacy and safety profile of four JAK inhibitors in rheumatoid arthritis: a French single-center observational study","journal_title":"Clinical Rheumatology","journal_issn":"0770-3198","published_at":"2026-06-04T00:00:00.000Z","url":"https://doi.org/10.1007/s10067-026-08175-y","source_score":7,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-17T13:29:44.008Z","updated_at":"2026-06-17T13:29:44.008Z","tags":[{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"age_group","value":"older_adult","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"brand","value":"Jyseleca","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"brand","value":"Olumiant","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"brand","value":"Rinvoq","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"brand","value":"Xeljanz","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"condition","value":"Rheumatoid Arthritis","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"generic","value":"baricitinib","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"generic","value":"filgotinib","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"generic","value":"tofacitinib","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"generic","value":"upadacitinib","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"impact_flag","value":"safety_signal","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"sample_size","value":"n=120","value_numeric":120},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"study_design","value":"Retrospective Observational Cohort Study","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"warning","value":"Adverse events not leading to discontinuation were not systematically captured, so non-severe infections and minor adverse effects are likely underreported.","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"warning","value":"Filgotinib was prescribed exclusively to women in this cohort due to early spermatogenesis concerns, limiting the generalizability of its effectiveness and persistence data to male patients.","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"warning","value":"Inter-JAKi comparisons are confounded by substantial differences in patient selection, timing of drug availability, and follow-up duration rather than true pharmacological differences.","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08175-y","tag_type":"warning","value":"Tofacitinib subgroup was very small (n=10), so any efficacy or safety conclusions for that agent alone should be interpreted with caution.","value_numeric":null}],"summaries":{"what_studied":"Real-world treatment maintenance, effectiveness, and safety of four JAK inhibitors (tofacitinib, baricitinib, upadacitinib, filgotinib) in 120 RA patients at a single French center (April 2018–November 2023), including a before-vs-after comparison of the October 2022 EMA PRAC prescribing restrictions.","key_result":"Overall drug survival was 73% at 12 months, 62% at 24 months, and 57% at 36 months. All four JAKi reduced DAS28-CRP by –1.57 ± 1.26 at 6 months and –1.13 ± 1.63 at 12 months. Serious cardiovascular/thromboembolic events (3 pulmonary embolisms, 1 myocardial infarction) occurred only in high-risk patients treated before PRAC; zero such events occurred after PRAC.","limitations":"- Single-center retrospective design limits generalizability.\n- Filgotinib had much shorter follow-up than other agents, making long-term persistence comparisons unreliable.\n- Adverse events were only captured when they caused discontinuation, likely underestimating the true safety burden.","practice_takeaway":"Screen RA patients carefully for cardiovascular and thromboembolic risk before starting any JAK inhibitor — all serious vascular events in this cohort occurred in high-risk patients predating PRAC restrictions. After PRAC-aligned patient selection, baricitinib suits older, more comorbid patients; upadacitinib fits high-disease-burden cases; and filgotinib is a reasonable choice for younger, lower-risk women."}},{"doi":"10.1007/s10067-026-08168-x","pmid":"42217099","title":"Longitudinal clinical response to Janus kinase inhibitors in systemic sclerosis: a real-life multicentric study across multiple clinical domains","journal_title":"Clinical Rheumatology","journal_issn":"0770-3198","published_at":"2026-05-30T00:00:00.000Z","url":"https://doi.org/10.1007/s10067-026-08168-x","source_score":1,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-06-05T13:26:34.859Z","updated_at":"2026-06-05T13:26:34.859Z","tags":[{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"age_group","value":"adult","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"brand","value":"Jyseleca","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"brand","value":"Olumiant","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"brand","value":"Rinvoq","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"brand","value":"Xeljanz","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"condition","value":"Calcinosis Cutis","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"condition","value":"Digital Ulcers","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"condition","value":"Interstitial Lung Disease","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"condition","value":"Systemic Sclerosis","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"generic","value":"baricitinib","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"generic","value":"filgotinib","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"generic","value":"tofacitinib","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"generic","value":"upadacitinib","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"impact_flag","value":"limited_evidence","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"level_of_evidence","value":"4","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"sample_size","value":"n=32","value_numeric":32},{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"study_design","value":"Retrospective Cohort Study","value_numeric":null},{"paper_doi":"10.1007/s10067-026-08168-x","tag_type":"warning","value":"Sample is predominantly female (91%) and from 4 centers in 3 European countries (Italy >50%), limiting generalizability. No adjustment for multiple comparisons was made; the significant mRSS p-value (0.03) should be interpreted cautiously. The 24-month subgroup (n=8) is too small for inferential conclusions. Brand name tags are inferred from generic drug names; the paper does not explicitly list brand names.","value_numeric":null}],"summaries":{"what_studied":"This international, multicentric, retrospective cohort study evaluated real-world safety and effectiveness of JAK inhibitors (baricitinib, filgotinib, tofacitinib, upadacitinib) in 32 SSc patients across pulmonary (FVC%, DLCO%), cutaneous (mRSS), articular (TJC/SJC), digital ulcer, and calcinosis domains over a median follow-up of 16.9 months.","key_result":"At 12 months, mRSS improved significantly (SMC −0.29, p=0.03), and joint counts showed large improvements (TJC: SMC −1.19, p<0.001; SJC: SMC −0.69, p=0.001). Pulmonary function remained stable (FVC% SMC +0.22, p=0.10; DLCO% SMC +0.23, p=0.33). Among 11 patients with calcinosis, 45.5% improved. DU incidence was 21 events per 100 patient-years. Glucocorticoid dose trended down from 6.9 to 2.3 mg/day at 12 months (SMC −0.91, p=0.069). Drug discontinuation occurred in 53% of patients, with safety-related stops in ~28%.","limitations":"- No control group; causal inference is not possible, and regression to the mean cannot be excluded.\n- Very small sample at 24 months (n=8), severely limiting later timepoint conclusions.\n- No pre-specified primary endpoint; multiple outcomes tested without correction for multiple comparisons, raising type I error risk.","practice_takeaway":"JAKi therapy in SSc showed real-world signals of skin and joint benefit, with pulmonary stabilization, but high discontinuation rates (~53%) and confirmed safety concerns (infections, hematologic events) warrant caution. These findings are exploratory — prescribe JAKi in SSc only in selected patients with active inflammatory features, and await controlled trial data before broader adoption."}},{"doi":"10.1016/j.ard.2026.03.030","pmid":"42067428","title":"Impact of tofacitinib on growth in patients with juvenile idiopathic arthritis","journal_title":"Annals of the Rheumatic Diseases","journal_issn":"0003-4967","published_at":"2026-04-30T00:00:00.000Z","url":"https://doi.org/10.1016/j.ard.2026.03.030","source_score":24,"is_retracted":false,"is_open_access":true,"raw_metadata":{"pubmed":true,"crossref":true,"unpaywall":true},"created_at":"2026-09-13T06:21:54.675Z","updated_at":"2026-09-13T06:21:54.675Z","tags":[{"paper_doi":"10.1016/j.ard.2026.03.030","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.03.030","tag_type":"brand","value":"Xeljanz","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.03.030","tag_type":"category","value":"Rheumatology","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.03.030","tag_type":"condition","value":"Juvenile Idiopathic Arthritis","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.03.030","tag_type":"generic","value":"tofacitinib","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.03.030","tag_type":"impact_flag","value":"confirms_prior","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.03.030","tag_type":"level_of_evidence","value":"3","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.03.030","tag_type":"modality","value":"JAK Inhibitor","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.03.030","tag_type":"sample_size","value":"n=225","value_numeric":225},{"paper_doi":"10.1016/j.ard.2026.03.030","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.03.030","tag_type":"study_design","value":"Post Hoc Analysis","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.03.030","tag_type":"warning","value":"Biomarker analysis was conducted in a subset of 137 patients over only 18 weeks, which may not reflect long-term endocrine effects.","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.03.030","tag_type":"warning","value":"No comparator arm (e.g., methotrexate or biologic DMARD) was included, making it difficult to isolate tofacitinib's specific contribution to growth outcomes.","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.03.030","tag_type":"warning","value":"Post hoc design: causality cannot be established; results should be interpreted with caution.","value_numeric":null},{"paper_doi":"10.1016/j.ard.2026.03.030","tag_type":"warning","value":"The brand name 'Xeljanz' was inferred from tofacitinib; confirm proprietary name applies to the pediatric formulation used in this trial.","value_numeric":null}],"summaries":{"what_studied":"This post hoc analysis evaluated the effect of long-term tofacitinib (a JAK inhibitor) on growth velocity, height Z-scores, and biomarkers of growth hormone (GH) function and bone metabolism in 225 patients with JIA (primarily polyarticular-course), with a median follow-up of 3.6 years.","key_result":"Children ≤12 years showed greater-than-expected height velocities; those >12 years grew as expected for age. Height Z-scores were largely stable overall, but pubertal patients with a baseline height Z-score < −1.0 showed a significant increase in height Z-score at 24 months (P < .05). IGF-1 levels rose from baseline to 18 weeks in patients aged 6–12 years; IGF-1, IGFBP-3, and osteocalcin were unchanged in the overall population.","limitations":"Post hoc design limits causal inference. No control arm means growth outcomes cannot be definitively attributed to tofacitinib vs. disease improvement or natural history. Biomarker data were available for only a subset (n=137) over a short 18-week window.","practice_takeaway":"Tofacitinib does not appear to suppress growth in children with JIA and may support catch-up growth in shorter pubertal patients. Clinicians can be reassured that long-term tofacitinib use is not associated with concerning changes in GH signaling or bone metabolism markers."}},{"doi":"10.1002/resp.70248","pmid":"41983711","title":"Upadacitinib Versus Tofacitinib in Anti‐\n MDA5\n ‐Positive Dermatomyositis With Interstitial Lung Disease: A Multi‐Centre Cohort Study Emulating a Target Trial","journal_title":"Respirology","journal_issn":"1323-7799","published_at":"2026-04-15T00:00:00.000Z","url":"https://doi.org/10.1002/resp.70248","source_score":34,"is_retracted":false,"is_open_access":false,"raw_metadata":{"ooir":{"day":"2026-04-17","doi":"10.1002/resp.70248","days":"30","issn":"1323-7799","rank":"5","field":"Clinical Medicine","score":"34","category":"Respiratory System","categories":["Respiratory System"],"_categories":["Respiratory System"]},"pubmed":{"doi":"10.1002/resp.70248","title":"Upadacitinib Versus Tofacitinib in Anti-MDA5-Positive Dermatomyositis With Interstitial Lung Disease: A Multi-Centre Cohort Study Emulating a Target Trial.","journal":"Respirology (Carlton, Vic.)","methods":"","results":"In the eligible cohort, a total of 106 patients were treated with UPA and 328 with TOFA. The crude 6-month lung transplantation-free survival rates were 71.7% (76/106) in the UPA group and 67.4% (221/328) in the TOFA group. In the IPTW-adjusted cohort, UPA showed a trend toward higher survival than TOFA (p = 0.067), with a weighted risk difference of 10.3% (95% confidence interval -0.4% to 20.2%) meeting the non-inferiority margin (non-inferiority p = 0.003). Sensitivity and subgroup analyses showed consistent results, with potentially greater benefit of UPA in incident JAK inhibitor users (as first-line treatment), monotherapy recipients (without combination with other immunosuppressants except steroid), and those with rapidly progressive ILD. Safety profiles were comparable between groups.","abstract":"$30","keywords":["MDA5","dermatomyositis","interstitial lung disease","tofacitinib","upadacitinib"],"pubmed_id":"41983711","conclusions":"UPA was found to be non-inferior to TOFA in improving 6-month lung transplantation-free survival among patients with 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Total sample size of 434 is derived from 106 (UPA) + 328 (TOFA) as reported.","value_numeric":null},{"paper_doi":"10.1002/resp.70248","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously—this is an observational cohort study with IPTW, not a true RCT; results should be interpreted as hypothesis-generating pending prospective confirmation.","value_numeric":null}],"summaries":{"what_studied":"This multi-centre cohort study from China compared upadacitinib (UPA) vs. tofacitinib (TOFA) for 6-month lung transplantation-free survival in newly diagnosed anti-MDA5-positive dermatomyositis with interstitial lung disease (MDA5+DM-ILD), enrolling patients treated January 2020–February 2025 and using inverse probability treatment weighting (IPTW) to emulate a randomized trial.","key_result":"UPA was non-inferior to TOFA (non-inferiority p = 0.003); crude 6-month lung transplantation-free survival was 71.7% (76/106) with UPA vs. 67.4% (221/328) with TOFA; IPTW-adjusted weighted risk difference was +10.3% (95% CI −0.4% to 20.2%) favoring UPA, though the superiority trend did not reach significance (p = 0.067). Subgroup analyses suggested potentially greater UPA benefit in first-line JAK inhibitor users, monotherapy recipients, and rapidly progressive ILD.","limitations":"Observational design with IPTW emulation cannot fully replace a true RCT; unmeasured confounding (e.g., disease severity nuances, physician preference) may persist. Study was conducted entirely in China, limiting generalizability to other populations. The 6-month endpoint may miss longer-term divergence in outcomes or late adverse effects.","practice_takeaway":"For patients with MDA5+DM-ILD, upadacitinib appears at least as effective as tofacitinib at 6 months, with a comparable safety profile—making it a reasonable alternative, particularly as first-line JAK inhibitor therapy or in rapidly progressive ILD. Clinicians should note this is observational evidence; prospective RCT confirmation is still needed."}}],"initialOffset":10,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"brand","value":"Xeljanz"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Brands","href":"/hub/tag/brand"},{"name":"Xeljanz"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"brand","hub_tag_value":"Xeljanz"}}}]]

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