为了确定2021年1月发布的口服类风湿关节炎试验（ORAL）监测试验结果是否改变了Janus激酶抑制剂（JAKi）、肿瘤坏死因子抑制剂（TNFi）和非TNFi生物制剂的处方规律。这是一项回顾性研究，研究对象为2012年1月至2022年9月在美国退伍军人事务部健康系统接受先进治疗的成年类风湿关节炎（RA）患者。符合条件的患者需要至少有一个RA的诊断代码，并且在治疗过程中接受生物制剂改变疾病进展的抗风湿药物或JAKi。治疗过程根据药房发药数据定义，每种先进治疗的新疗程数量被统计出来。我们评估了安全性数据发布前后每种治疗的使用情况的变化（2021年1月）。 研究涵盖了88,253个个体用药疗程（34,656名独特患者），其中符合研究条件的患者用药数据包括在研究中。到2021年1月，JAKi的新疗程数量和比例一直在持续增加，之后在2022年9月发生了明显的净减少。在安全性数据发布后，托法替尼的使用显著减少，其使用变化的斜率也有显著差异。相反，在2021年1月之前，TNFi的使用量下降，但在2021年1月后显著增加。 处方规律对新证据的响应强调了安全性试验对处方实践的影响。在这个领域进行持续的研究，并关注特定患者特征和风险特点，将有助于了解这些实践变化的特征。 © 2023 The Authors. ACR Open Rheumatology由Wiley Periodicals LLC代表美国风湿病学院出版。本文由美国政府雇员投稿，其工作在美国公共领域。

To determine whether prescribing practices for Janus kinase inhibitors (JAKi), tumor necrosis factor inhibitors (TNFi), and non-TNFi biologic agents changed after the results of the Oral Rheumatoid Arthritis Trial (ORAL) Surveillance trial were released in January 2021.This is a retrospective study in adult patients with rheumatoid arthritis (RA) receiving advanced therapies within the Veterans Affairs Health System from January 2012 through September 2022. Eligible patients were required to have at least one diagnosis code for RA and to have received a biologic disease-modifying antirheumatic drug or JAKi. Treatment courses were defined from pharmacy dispensing data and the number of new courses of each advanced therapy was quantified over time. We assessed changes in the use of each therapy before and after the release of safety data (January 2021).A total of 88,253 individual drug courses (in 34,656 unique patients) were included in the study. There was a consistent increase in the number and proportion of new courses of JAKi leading up to January 2021, which was followed by a significant net decrease in JAKi use through September 2022. There was significantly less tofacitinib use after the release of safety data, with a significant difference in the slope of change in use with time. In contrast, whereas TNFi use declined leading up to 2021, its use significantly increased after January 2021.Changes in prescribing in response to new evidence emphasize the impact that safety trials have on prescribing practices. Ongoing study in this area, with attention to specific patient characteristics and risk profiles, will help characterize these changes in practice.© 2023 The Authors. ACR Open Rheumatology published by Wiley Periodicals LLC on behalf of American College of Rheumatology. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.