本研究评估了12个月内接受雅努斯激酶抑制剂（upadacitinib，baricitinib，tofacitinib）和肿瘤坏死因子抑制剂（adalimumab）治疗的类风湿性关节炎（RA）患者的依从性和持续性。该回顾性分析使用了Merative™ MarketScan®研究数据库（2018-2022）中的行政索赔数据。符合条件的成年人在索引日期之前应具有≥1个类风湿性关节炎诊断、≥1个索引药物的药店索赔以及在索引日期之前和之后连续12个月的保险登记。在随访的12个月期间，评估了治疗依从性（定义为治疗期间覆盖天数的比例≥80%）、治疗中断的风险和中断的平均时间。报告了调整后的比值比（aOR）、调整后的风险比（aHR）和95%的置信区间（CI）。共计6317名患者被纳入研究（683例upadacitinib，3732例adalimumab，132例baricitinib，1770例tofacitinib）。与upadacitinib相比，启动adalimumab（aOR（95% CI）：0.82（0.69, 0.96））、baricitinib（0.46（0.31, 0.68））和tofacitinib（0.74（0.62, 0.88））的患者更不可能达到PDC≥80%。与upadacitinib相比，接受adalimumab（aHR（95% CI）：1.14（1.01, 1.29））、baricitinib（1.48（1.16, 1.90））和tofacitinib（1.22（1.07, 1.38））治疗的患者治疗中断的风险较高。中断治疗的平均时间为256天（upadacitinib），249天（adalimumab），221天（baricitinib）和239天（tofacitinib）。在先前使用TNFi的患者中也观察到类似的结果。无论最近是否使用过TNFi，与adalimumab、baricitinib和tofacitinib相比，启动upadacitinib的RA患者在治疗的首12个月内更有可能保持依从性，并较少中断治疗。© 2023. 作者。

This study evaluated 12 months adherence and persistence among Janus kinase inhibitors (upadacitinib, baricitinib, tofacitinib) and adalimumab, a tumor necrosis factor inhibitor (TNFi), in patients with rheumatoid arthritis (RA).This retrospective analysis used administrative claims data from the Merative™ MarketScan® Research Databases (2018-2022). Eligible adults had ≥ 1 RA diagnosis before the index date, ≥ 1 pharmacy claim for index medication, and ≥ 12 months of continuous insurance enrollment pre- and post-index. Adherence to treatment [defined as proportion of days covered (PDC) ≥ 80%], risk of treatment discontinuation, and mean time to discontinuation were assessed during the 12 months follow-up. Adjusted odds ratios (aOR), adjusted hazard ratios (aHR), and 95% confidence intervals (CI) were reported.In total, 6317 patients were included (683 upadacitinib, 3732 adalimumab, 132 baricitinib, 1770 tofacitinib). Compared with upadacitinib, patients initiating adalimumab [aOR (95% CI): 0.82 (0.69, 0.96)], baricitinib [0.46 (0.31, 0.68)], and tofacitinib [0.74 (0.62, 0.88)] were significantly less likely to achieve PDC ≥ 80%. Risk of treatment discontinuation was significantly higher in patients treated with adalimumab [aHR (95% CI): 1.14 (1.01, 1.29)], baricitinib [1.48 (1.16, 1.90)], and tofacitinib [1.22 (1.07, 1.38)] compared with upadacitinib. Mean time to discontinuation was 256 (upadacitinib), 249 (adalimumab), 221 (baricitinib), and 239 (tofacitinib) days. Similar results were observed in patients with prior TNFi use.Patients with RA, regardless of recent TNFi experience, initiating upadacitinib were significantly more likely to be adherent and less likely to discontinue therapy compared to adalimumab, baricitinib, and tofacitinib in the first 12 months of treatment.© 2023. The Author(s).