Real-world experience with filgotinib for rheumatoid arthritis in Germany : Aretrospective chart review.

Abstract

Real-world data for filgotinib, aJanus kinase (JAK)1 inhibitor, are limited in patients with rheumatoid arthritis (RA). To explore real-world filgotinib use in patients with RA in Germany. This retrospective chart review included patients aged ≥ 18years with confirmed moderate to severe RA who initiated filgotinib before December1, 2021, with ≥ 6months of medical records available prior to filgotinib initiation or after initial diagnosis. Patient characteristics, prior treatments, reasons for initiating/discontinuing filgotinib, disease activity, dose adjustments and concomitant treatments were recorded. In total, 301 patients from 20 German rheumatology outpatient units were included. One-third were aged ≥ 65years and almost half had ≥ 1 cardiovascular (CV) risk factor. Most patients initiated filgotinib as monotherapy (83.7%; 12.7% of whom with glucocorticoids) and at the 200 mg dose (84.7%); higher proportions of those initiating the 100 versus 200 mg dose were aged ≥ 65years and had renal impairment or ≥ 1 CV risk factor. Oral administration (78.4%), fast onset of action (66.8%) and administration as monotherapy (65.4%) were the most common reasons for initiating filgotinib. At 12months, 41 (18.4%) patients had discontinued filgotinib, most commonly due to lack of effectiveness. After 6‑months of follow-up, 36.8% of patients had achieved Clinical Disease Activity Index (CDAI) remission and 45.6% had achieved CDAI low disease activity. In clinical practice in Germany, reasons for initiating filgotinib in patients with RA were related to dosing flexibility and general JAK inhibitor attributes. Filgotinib was used predominantly as monotherapy and was effective and generally well tolerated; however, longer-term data in larger, prospective cohorts are needed.