Zahir Hussain Wajith Hussain, Jubber Ameen, Moorthy Arumugam
Department of Rheumatology, University Hospitals of Leicester NHS Trust, Leicester, GBR.
College of Life Sciences, University of Leicester, Leicester, GBR.
Cureus. 2021 Nov 29;13(11):e20024. doi: 10.7759/cureus.20024. eCollection 2021 Nov.
Introduction Baricitinib is an oral synthetic Janus Kinase inhibitor that inhibits JAK1 and JAK2, and the new kid on the block in the treatment of rheumatoid arthritis (RA). To date, there are no studies comparing the clinical benefit of baricitinib in RA between different ethnicities. Ethnicity plays a role in the effectiveness of therapeutic agents. Given the large multi-ethnic population of Leicestershire in the United Kingdom and the range of new therapeutics in RA, we reviewed our cohort of patients with RA to see whether there is any difference in baricitinib Disease Activity Score 28 (DAS28) response between the Asian and White cohorts. Methods This was a retrospective study. The patients included were those under the care of rheumatology at University Hospitals of Leicester (UHL) with a diagnosis of RA and either receiving baricitinib or had received it in the past. Data was collected using the UHL information technology systems, clinic letters and pharmacy records. In addition to ethnicity, we reviewed patient age, gender, concurrent disease-modifying anti-rheumatic drugs (DMARDs) used, previous biologics used, baseline and post-treatment DAS28, dropout from therapy, baseline biochemical assays (anti-cyclic citrullinated peptide (anti-CCP) and rheumatoid factor (RF) status) and radiographic findings. An independent t-test was used to compare continuous data, and Pearson's chi-squared test was used to compare categorical data. Results A total of 120 patients were included in the analysis, and data were analysed with Portable Format for Analytics (PFA). There was no statistically significant difference in the mean DAS28 at baseline (Asian: 5.17 versus White: 4.65; p-value = 0.107) and post-treatment (Asian: 2.8 versus White: 3.3; p-value = 0.404). Comparing both ethnicities, there was no statistically significant difference in previous biologics used, anti-CCP and RF titres, and radiographic findings of erosions. Conclusion This is the first study of its kind, and it found no significant difference in baricitinib response between the Asian and White cohorts. Our study had certain limitations, and future studies will be needed to evaluate this subject further. Such data is important as it can contribute to a body of evidence that may in the future help inform clinical decision-making.
简介
巴瑞替尼是一种口服合成的 Janus 激酶抑制剂，可抑制 JAK1 和 JAK2，是类风湿关节炎（RA）治疗领域的新成员。迄今为止，尚无研究比较不同种族中使用巴瑞替尼治疗 RA 的临床获益情况。种族在治疗药物的疗效中发挥着作用。鉴于英国莱斯特郡有大量多民族人口以及 RA 领域有多种新型治疗方法，我们回顾了我们的 RA 患者队列，以观察亚洲和白种人队列在巴瑞替尼治疗的 28 关节疾病活动评分（DAS28）反应上是否存在差异。
方法
这是一项回顾性研究。纳入的患者为在莱斯特大学医院（UHL）接受风湿病护理且诊断为 RA、正在接受或既往接受过巴瑞替尼治疗的患者。数据通过 UHL 信息技术系统、临床信件和药房记录收集。除种族外，我们还回顾了患者年龄、性别、同时使用的改善病情抗风湿药物（DMARDs）、既往使用的生物制剂、基线和治疗后的 DAS28、治疗中断情况、基线生化检测（抗环瓜氨酸肽（抗 CCP）和类风湿因子（RF）状态）以及影像学检查结果。采用独立 t 检验比较连续数据，采用 Pearson 卡方检验比较分类数据。
结果
共有 120 名患者纳入分析，并使用分析便携式格式（PFA）进行数据分析。基线时平均 DAS28（亚洲人：5.17 对比白种人：4.65；p 值 = 0.107）和治疗后（亚洲人：2.8 对比白种人：3.3；p 值 = 0.404）均无统计学显著差异。比较两个种族，在既往使用的生物制剂、抗 CCP 和 RF 滴度以及侵蚀的影像学检查结果方面均无统计学显著差异。
结论
这是同类研究中的首例，研究发现亚洲和白种人队列在巴瑞替尼反应方面无显著差异。我们的研究存在一定局限性，未来需要进一步研究以评估该主题。此类数据很重要，因为它可为未来可能有助于指导临床决策的证据体系做出贡献。
