Characterizing the Use of Janus Kinase Inhibitors (JAKi) in Five European Countries: A Drug Utilization Study
Author(s)
Xihang Chen, MMath1, Andrei Barbulescu, PhD2, George Corby, Medical Student1, Alexa Escudero Siosi, MD1, Saeed Hayati, MSc3, Annika Joedicke, PhD1, Toni Lehtonen, MSc4, Hedvig Nordeng, PhD3, Alexandra Pacurariu, PhD2, Gabriel Sanfélix-Gimeno, PharmD PhD5, Nhung Trinh, PhD3, Katia Verhamme, MD PhD6, Dina Vojinovic, MD PhD7, Tiina Wahlfors, PhD4, Daniel Prieto-Alhambra, MD PhD8, Amy S. Lam, PhD1, Edward Burn, PhD1.
1University of Oxford, Oxford, United Kingdom, 2European Medicines Agency, Amsterdam, Netherlands, 3University of Oslo, Oslo, Norway, 4Finnish Institute for Health and Welfare, Finland, Finland, 5Fundació per al Foment de la Investigació Sanitària i Biomèdica de la Comunitat Valenciana, Valencia, Spain, 6Erasmus Medical Center, Rotterdam, Netherlands, 7IQVIA, Amsterdam, Netherlands, 8University of Oxford, Centre for Statistics in Medicine, NDORMS, Oxford, United Kingdom.
1University of Oxford, Oxford, United Kingdom, 2European Medicines Agency, Amsterdam, Netherlands, 3University of Oslo, Oslo, Norway, 4Finnish Institute for Health and Welfare, Finland, Finland, 5Fundació per al Foment de la Investigació Sanitària i Biomèdica de la Comunitat Valenciana, Valencia, Spain, 6Erasmus Medical Center, Rotterdam, Netherlands, 7IQVIA, Amsterdam, Netherlands, 8University of Oxford, Centre for Statistics in Medicine, NDORMS, Oxford, United Kingdom.
OBJECTIVES: Janus Kinase inhibitors (JAKi) are increasingly used for the treatment of several autoimmune conditions, while there are safety concerns including elevated risks of cardiovascular events, cancer, and infections. This study aims to estimate the incidence of new JAKi use over time, and to characterise new JAKi users in Europe to inform the feasibility of future safety studies.
METHODS: The study included all individuals with at least 365 days of prior medical history in five data sources (FinOMOP-HILMO [Finland], IPCI [the Netherlands], IQVIA-DA [Germany], NLHR [Norway], VID [Spain]) within the DARWIN-EU® network from 1-Jan-2017 until the most recent data lock. Annual incidence rates of JAKi prescribing (abrocitinib, baricitinib, filgotinib, tofacitinib, upadacitinib) were estimated. Patient characteristics and treatment duration were described.
RESULTS: Tofacitinib had the highest number of initiators, ranging from 160 (VID) to 2,129 (FinOMOP-HILMO). Abrocitinib had the lowest count, with only 16 from IPCI and 298 from NLHR. Over the study period, the incidence of JAKi use increased from 3.1 to 14.0/100,000 person-years in FinOMOP-HILMO, 2.0 to 6.0 in IPCI, 2.3 to 15.6 in IQVIA-DA, 10.7 to 21.2 in NLHR and 4.7 to 8.9 in VID. Most JAKi initiators were aged 41-60 and had a history of rheumatoid arthritis, except for abrocitnib which was mostly started in individuals with atopic dermatitis before the age of 40. A variable proportion of JAKi initiators with rheumatoid arthritis were previously treated with different JAKi. Treatment duration was consistent across different JAKi, with median ranging from 3-9 months for filgotinib among databases to 4-10 months for abrocitinib.
CONCLUSIONS: Tofacitinib was the most initiated JAKi whilst abrocitinib was the least. Incidence of JAKi use increased from 2017 to 2023. Except for abrocitinib, most JAKi initiators were aged 41-60. Average duration of index JAKi treatment was generally less than a year, while switching of JAKi was not uncommon.
METHODS: The study included all individuals with at least 365 days of prior medical history in five data sources (FinOMOP-HILMO [Finland], IPCI [the Netherlands], IQVIA-DA [Germany], NLHR [Norway], VID [Spain]) within the DARWIN-EU® network from 1-Jan-2017 until the most recent data lock. Annual incidence rates of JAKi prescribing (abrocitinib, baricitinib, filgotinib, tofacitinib, upadacitinib) were estimated. Patient characteristics and treatment duration were described.
RESULTS: Tofacitinib had the highest number of initiators, ranging from 160 (VID) to 2,129 (FinOMOP-HILMO). Abrocitinib had the lowest count, with only 16 from IPCI and 298 from NLHR. Over the study period, the incidence of JAKi use increased from 3.1 to 14.0/100,000 person-years in FinOMOP-HILMO, 2.0 to 6.0 in IPCI, 2.3 to 15.6 in IQVIA-DA, 10.7 to 21.2 in NLHR and 4.7 to 8.9 in VID. Most JAKi initiators were aged 41-60 and had a history of rheumatoid arthritis, except for abrocitnib which was mostly started in individuals with atopic dermatitis before the age of 40. A variable proportion of JAKi initiators with rheumatoid arthritis were previously treated with different JAKi. Treatment duration was consistent across different JAKi, with median ranging from 3-9 months for filgotinib among databases to 4-10 months for abrocitinib.
CONCLUSIONS: Tofacitinib was the most initiated JAKi whilst abrocitinib was the least. Incidence of JAKi use increased from 2017 to 2023. Except for abrocitinib, most JAKi initiators were aged 41-60. Average duration of index JAKi treatment was generally less than a year, while switching of JAKi was not uncommon.
Conference/Value in Health Info
2025-11, ISPOR Europe 2025, Glasgow, Scotland
Value in Health, Volume 28, Issue S2
Code
EPH40
Topic
Epidemiology & Public Health, Real World Data & Information Systems
Topic Subcategory
Safety & Pharmacoepidemiology
Disease
Systemic Disorders/Conditions (Anesthesia, Auto-Immune Disorders (n.e.c.), Hematological Disorders (non-oncologic), Pain)