Keystone Edward C, Taylor Peter C, Tanaka Yoshiya, Gaich Carol, DeLozier Amy M, Dudek Anna, Zamora Jorge Velasco, Cobos Jose Arturo Covarrubias, Rooney Terence, Bono Stephanie de, Arora Vipin, Linetzky Bruno, Weinblatt Michael E
The Rebecca MacDonald Centre for Arthritis, Mt. Sinai Hospital, Toronto, Canada.
Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK.
Ann Rheum Dis. 2017 Nov;76(11):1853-1861. doi: 10.1136/annrheumdis-2017-211259. Epub 2017 Aug 10.
To assess the effect of baricitinib on patient-reported outcomes (PROs) in patients with active rheumatoid arthritis and an inadequate response to methotrexate (MTX).
In this double-blind phase 3 study, patients were randomised 3:3:2 to placebo (n=488), baricitinib 4 mg once daily (n=487), or adalimumab 40 mg biweekly (n=330) with background MTX. PROs included the SF-36, EuroQol 5-D (EQ-5D) index scores and visual analogue scale, Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F), Health Assessment Questionnaire-Disability Index (HAQ-DI), Patient's Global Assessment of Disease Activity (PtGA), patient's assessment of pain and Work Productivity and Activity Impairment Questionnaire-Rheumatoid Arthritis (WPAI-RA), and measures collected in electronic patient daily diaries: duration and severity of morning joint stiffness (MJS), Worst Ttiredness and Worst Joint Pain. The primary study endpoint was at week 12. Treatment comparisons were assessed with logistic regression for categorical measures or analysis of covariance for continuous variables.
Compared with placebo and adalimumab, baricitinib showed statistically significant improvements (p≤0.05) in HAQ-DI, PtGA, pain, FACIT-F, SF-36 physical component score, EQ-5D index scores and WPAI-RA daily activity at week 12. Improvements were maintained for measures assessed to week 52. Statistically significant improvement in patient diary measures (MJS duration and severity), worst tiredness and worst joint pain were observed for baricitinib versus placebo and adalimumab at week 12 (p≤0.05).
Baricitinib provided significantly greater improvement in most PROs compared with placebo and adalimumab, including physical function MJS, pain, fatigue and quality of life. Improvement was maintained to the end of the study (week 52).
NCT01710358.
评估巴瑞替尼对活动性类风湿关节炎且对甲氨蝶呤(MTX)反应不足患者的患者报告结局(PROs)的影响。
在这项双盲3期研究中,患者按3:3:2随机分为安慰剂组(n = 488)、每日一次巴瑞替尼4 mg组(n = 487)或每两周一次阿达木单抗40 mg组(n = 330),均联合背景MTX治疗。PROs包括SF - 36、欧洲五维健康量表(EQ - 5D)指数评分和视觉模拟量表、慢性病治疗功能评估 - 疲劳量表(FACIT - F)、健康评估问卷 - 残疾指数(HAQ - DI)、患者对疾病活动的整体评估(PtGA)、患者对疼痛的评估以及工作效率和活动障碍问卷 - 类风湿关节炎(WPAI - RA),以及电子患者每日日记中收集的指标:晨僵(MJS)的持续时间和严重程度、最严重疲劳和最严重关节疼痛。主要研究终点为第12周。分类指标采用逻辑回归分析,连续变量采用协方差分析进行治疗组间比较。
与安慰剂和阿达木单抗相比,巴瑞替尼在第12周时在HAQ - DI、PtGA、疼痛、FACIT - F、SF - 36身体成分评分、EQ - 5D指数评分和WPAI - RA日常活动方面显示出统计学显著改善(p≤0.05)。这些改善在评估至第52周的指标中得以维持。与安慰剂和阿达木单抗相比,第12周时巴瑞替尼在患者日记指标(MJS持续时间和严重程度)、最严重疲劳和最严重关节疼痛方面有统计学显著改善(p≤0.05)。
与安慰剂和阿达木单抗相比,巴瑞替尼在大多数PROs方面有显著更大的改善,包括身体功能、MJS、疼痛、疲劳和生活质量。改善持续至研究结束(第52周)。
NCT01710358。