JAK2 mutation may predict response and guide first line treatment in rheumatoid arthritis

Abstract Background JAK (Janus kinase) inhibitors work by inhibiting the activity of one or more enzyme Janus kinase with a therapeutic application for treatment cancer and inflammatory disorders such as rheumatoid arthritis (RA). We aimed to study impact JAK2 mutation in serum patients on response first line conventional synthetic disease-modifying anti-rheumatic drug (csDMARDS) at 3rd month evaluating DAS28 ACR criteria. The included 85 newly diagnosed 50 matched controls. Basal assessed PCR blood samples, TNF-α IL 6 were measured ELISA patient control groups. All started therapy csDMARDs. Response assessment was evaluated correlated different clinical laboratory parameters patients. Results Seventeen females (83.5%) 14 males (16.5%) age mean ± SD (years); (48.7 7.2). Pretreatment mutation, significantly high detected 45 (52.9%) while 40 (47.1%) non-mutant. Mutant linked severity disease DAS28; (70%) (≤ 2.6) non-mutant vs sex (30%) mutant 19 (73.1%) (> 5.1) 7 (26.9%) (P 0.02). found be 20, 50, 70 criteria; 68.2% showed 31.8% group, 52% 48% group 31.6% 20 68.4% ( P presented young (mean SD; 47.1 7.2 50.4 6.9 patients, respectively 0.03). associated pretreatment TNFα IL6 level serum. Mean TNFα; 49.4 41.9 26 24.4 pg/ml (0.003) IL6; 83.5 56.8 47 46.9 (0.002). Conclusions Adult RA levels. Patients poor 1st csDMARDs including MTX so they could get benefit early introduction monotherapy when combined csDMARDS especially those moderate severe active RA. Trial registration Institutional Research Board (IRB)-Faculty Medicine: IRB Proposal Code: R.20.11.1075-2020/11/16. Clinicaltrials.gov date: 8/12/2020, code: NCT04667988 .