We read with great interest the letter by Huang M. et al. [1] on the AMBI-RA study by our group [2], and we are grateful for their comments which permit to better elucidate the significance of our study. The AMBI-RA study examined changes in biological (b) and targeted synthetic (ts) disease modifying anti-rheumatic drugs (DMARDs) prescribing in rheumatoid arthritis (RA), before and after the EMA guidance on JAK inhibitors (JAKis) [3], using a single-center ambidirectional study design [2]. In multivariable analyses, EMA-defined cardiovascular risk factors did not emerge as statistically significant associations of JAKis avoidance, although their clinical relevance in treatment decisions cannot be excluded.
