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巴瑞替尼治疗中重度类风湿关节炎患者长达 6.5 年的疗效:一项长期研究结果。

Efficacy of baricitinib in patients with moderate-to-severe rheumatoid arthritis up to 6.5 years of treatment: results of a long-term study.

机构信息

Department of Clinical Sciences & Community Health, Research Center for Adult and Pediatric Rheumatic Diseases, Università degli Studi di Milano and ASST Gaetano Pini CTO, Milano, Italy.

Botnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.

出版信息

Rheumatology (Oxford). 2024 Oct 1;63(10):2799-2809. doi: 10.1093/rheumatology/keae012.

Abstract

OBJECTIVES

To evaluate the long-term efficacy of once-daily baricitinib 4 mg or 2 mg in patients with active rheumatoid arthritis who had inadequate response (IR) to MTX, csDMARDs or bDMARDs.

METHODS

Data from three completed phase III studies-RA-BEAM (MTX-IR), RA-BUILD (csDMARD-IR) and RA-BEACON (bDMARD-IR)-and one completed long-term extension study (RA-BEYOND) were analysed up to 6.5 years [340 weeks (RA-BEAM) and 336 weeks (RA-BUILD and RA-BEACON)]. Low disease activity (LDA) [Simplified Disease Activity Index (SDAI) ≤11], clinical remission (SDAI ≤3.3) and physical function [Health Assessment Questionnaire Disability Index (HAQ-DI) ≤0.5] were the main outcomes assessed. Completer and non-responder imputation (NRI) analyses were conducted on each population.

RESULTS

At week 340 or 336, LDA was achieved in 37%/83% of MTX-IR, 35%/83% of csDMARD-IR and 23%/73% of bDMARD-IR patients treated with baricitinib 4 mg, assessed by NRI/completer analyses, respectively. Remission was achieved in 20%/40% of MTX-IR, 13%/32% of csDMARD-IR and 9%/30% of bDMARD-IR patients treated with baricitinib 4 mg, assessed by NRI/completer analyses, respectively. HAQ-DI ≤0.5 was reached in 31%/51% of MTX-IR, 25%/46% of csDMARD-IR and 24%/38% of bDMARD-IR patients treated with baricitinib 4 mg, assessed by NRI/completer analyses, respectively.

CONCLUSION

Treatment with baricitinib 4 mg or 2 mg demonstrated efficacy up to 6.5 years with maintained LDA/remission results across SDAI, CDAI and DAS28-hsCRP consistent with previously reported data, and was well tolerated.

TRIAL REGISTRATION

United States National Library of Medicine clinical trials database www.clinicaltrials.gov; RA-BEYOND; NCT01885078.

摘要

目的

评估每日一次巴瑞替尼 4mg 或 2mg 在对甲氨蝶呤、csDMARDs 或 bDMARDs 应答不足(IR)的活动性类风湿关节炎患者中的长期疗效。

方法

对三项已完成的 III 期研究(MTX-IR、csDMARD-IR 和 bDMARD-IR)以及一项已完成的长期扩展研究(RA-BEYOND)的数据进行分析,时间长达 6.5 年[340 周(RA-BEAM)和 336 周(RA-BUILD 和 RA-BEACON)]。主要结局评估为低疾病活动度(SDAI≤11)、临床缓解(SDAI≤3.3)和躯体功能[健康评估问卷残疾指数(HAQ-DI)≤0.5]。对每个人群进行完全应答者分析和非应答者校正(NRI)分析。

结果

在第 340 或 336 周时,NRI/完全应答者分析显示,巴瑞替尼 4mg 治疗的 MTX-IR、csDMARD-IR 和 bDMARD-IR 患者中分别有 37%/83%、35%/83%和 23%/73%达到低疾病活动度;NRI/完全应答者分析显示,巴瑞替尼 4mg 治疗的 MTX-IR、csDMARD-IR 和 bDMARD-IR 患者中分别有 20%/40%、13%/32%和 9%/30%达到缓解;NRI/完全应答者分析显示,巴瑞替尼 4mg 治疗的 MTX-IR、csDMARD-IR 和 bDMARD-IR 患者中分别有 31%/51%、25%/46%和 24%/38%达到 HAQ-DI≤0.5。

结论

巴瑞替尼 4mg 或 2mg 治疗长达 6.5 年,SDAI、CDAI 和 DAS28-hsCRP 持续显示出低疾病活动度/缓解结果,与先前报告的数据一致,且具有良好的耐受性。

试验注册

美国国立医学图书馆临床试验数据库 www.clinicaltrials.gov;RA-BEYOND;NCT01885078。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e7e9/11443035/a85c06f02a7e/keae012f1.jpg

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