Abstract | OBJECTIVE: To evaluate the effect of baricitinib on inhibiting radiographic progression of structural joint damage over 5 years in patients with active rheumatoid arthritis (RA). METHODS: Patients completed 1 of 3 phase III baricitinib trials (ClinicalTrials.gov: NCT01711359, NCT01710358, or NCT01721057) and entered the long-term extension RA-BEYOND (NCT01885078), in which patients received once-daily 4 mg or 2 mg baricitinib. Across these trials, patients initially receiving methotrexate (MTX) or adalimumab (ADA) switched to baricitinib 4 mg at Week 52. Patients initially receiving placebo (PBO) switched to baricitinib 4 mg at Week 24. Radiographs were scored at baseline and Years 2, 3, 4, and 5. Change from baseline in van der Heijde modified total Sharp score (ΔmTSS) was computed. RESULTS: Overall, 2125 of 2573 (82.6%) randomized patients entered RA-BEYOND; 1837 of 2125 (86.4%) entered this analysis. From Years 3 to 5, higher proportions of disease-modifying antirheumatic drug ( DMARD)-naïve patients on initial baricitinib (monotherapy or with MTX) had no progression vs initial MTX (ΔmTSS ≤ 0 at Year 5: 59.6% baricitinib 4 mg; 66.2% baricitinib 4 mg + MTX; 40.7% MTX). Higher proportions of patients with inadequate response (IR) to MTX on initial baricitinib or ADA vs PBO had no progression (ΔmTSS ≤ 0 at Year 5: 54.8% baricitinib 4 mg; 55.0% ADA; 50.3% PBO). Higher proportions of patients with conventional synthetic DMARD-IR on initial baricitinib 4 mg had less progression vs initial PBO or baricitinib 2 mg (ΔmTSS ≤ 0 at Year 5: 66.7% baricitinib 4 mg; 58.2% baricitinib 2 mg; 60.0% PBO). CONCLUSION: Oral baricitinib maintained lower levels of radiographic progression than initial conventional synthetic DMARD or PBO through 5 years in patients with active RA.
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Authors | Désirée van der Heijde, Cynthia E Kartman, Li Xie, Scott Beattie, Douglas Schlichting, Daojun Mo, Patrick Durez, Yoshiya Tanaka, Roy Fleischmann |
Journal | The Journal of rheumatology
(J Rheumatol)
Vol. 49
Issue 2
Pg. 133-141
(02 2022)
ISSN: 0315-162X [Print] Canada |
PMID | 34526397
(Publication Type: Clinical Trial, Phase III, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Copyright | © 2022 by the Journal of Rheumatology. |
Chemical References |
- Antirheumatic Agents
- Azetidines
- Purines
- Pyrazoles
- Sulfonamides
- Adalimumab
- baricitinib
- Methotrexate
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Topics |
- Adalimumab
(therapeutic use)
- Antirheumatic Agents
(adverse effects)
- Arthritis, Rheumatoid
(diagnostic imaging, drug therapy)
- Azetidines
- Disease Progression
- Double-Blind Method
- Drug Therapy, Combination
- Humans
- Methotrexate
(therapeutic use)
- Purines
- Pyrazoles
- Sulfonamides
- Treatment Outcome
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