Baricitinib Lowers Structural Joint Damage in Patients With RA: Study

A group of researchers from the Netherlands conducted a study to evaluate the effect of baricitinib on inhibiting the radiographic progression of structural joint damage over 5 years in patients with active rheumatoid arthritis (RA). They stated, "Because no cure for RA exists, it is important to reduce a patient's inflammation to the lowest level possible to prevent structural damage from accruing and thereby maintaining patients' functional ability." 

Patients completed 1 of 3 phase 3 baricitinib trials and entered the long-term extension RA-BEYOND, in which patients received once-daily 4 mg or 2 mg baricitinib. Across these trials, patients initially receiving methotrexate (MTX) or adalimumab switched to baricitinib 4 mg at week 52. Patients initially receiving placebo 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.

The results of the study are as follows:

· Overall, 2125/2573 (82.6%) randomized patients entered RA-BEYOND; 1837/2125 (86.4%) entered this analysis.

· From years 3 to 5, higher proportions of DMARD-naïve patients on initial baricitinib (monotherapy; +MTX) had no progression versus initial MTX

· Higher proportions of patients with an inadequate response (IR) to MTX on initial baricitinib or adalimumab versus placebo had no progression

· Higher proportions of patients with conventional synthetic (cs)DMARD-IR on initial baricitinib 4 mg had less progression versus initial placebo or baricitinib 2 mg.

Thus, the researchers concluded that oral baricitinib maintained lower levels of radiographic progression than initial csDMARD or placebo through 5 years in patients with active rheumatoid arthritis (RA).

Reference:

A study titled, "Radiographic progression of structural joint damage over 5 years of baricitinib treatment in patients with rheumatoid arthritis: Results from RA-BEYOND" by Désirée van der Heijde et. al published in the Journal of Rheumatology.

DOI: 10.3899/jrheum.210346