MSK Research Unit, NIHR Southampton Clinical Research Facility, Southampton, UK.
Department of Internal Medicine, Saitama Medical University, Saitama, Japan.
Curr Med Res Opin. 2024 Nov;40(11):1993-2002. doi: 10.1080/03007995.2024.2416979. Epub 2024 Oct 22.
Baricitinib is an oral, reversible and selective inhibitor of Janus kinase (JAK)1 and JAK2 that is approved as monotherapy or in combination with methotrexate for the treatment of adults with moderate-to-severe active rheumatoid arthritis (RA) who have responded inadequately to disease-modifying antirheumatic drugs. Evidence supporting the approved monotherapy indication is growing in real-world settings that reflect routine clinical practice.
Results of separate analyses of real-world data from the observational prospective RA-BE-REAL, Erlangen Baricitinib cohort, the BSRBR-RA, and Swiss Clinical Quality Management in Rheumatic Diseases (SCQM) registries, and the retrospective ORBIT-RA and SUSTAIN long-term chart reviews were reported, documenting baseline data and outcomes for a total of 932 patients with active RA receiving baricitinib as monotherapy. Findings were contrasted with those from a total of 850 patients receiving the drug as combination therapy. All analyses were descriptive and completed in September 2022.
Across the patient registries and observational studies, 39.4%-69.6% of patients received baricitinib monotherapy for the treatment of active RA. In these patients, after about 6-12 months of treatment, 40.7%-93.8% and 55.6%-88.0% achieved remission or low disease activity according to the composite measures of disease activity 28-joint count and Clinical Disease Activity Index, respectively. Treatment continuation/discontinuation rates differed across the studies.
These findings suggest that baricitinib monotherapy can be a suitable treatment option in routine clinical practice for patients with RA, when used in accordance with current guidelines.
巴利昔替尼是一种口服、可逆和选择性的 Janus 激酶(JAK)1 和 JAK2 抑制剂,已被批准用于治疗对疾病修饰抗风湿药物反应不足的中重度活跃类风湿关节炎(RA)成人患者,该药可单药治疗或与甲氨蝶呤联合使用。在反映常规临床实践的真实世界环境中,支持批准的单药治疗适应证的证据不断增加。
分别分析了来自观察性前瞻性 RA-BE-REAL、埃尔朗根巴利昔替尼队列、BSRBR-RA 和瑞士风湿病临床质量管理(SCQM)登记处的真实世界数据以及回顾性 ORBIT-RA 和 SUSTAIN 长期图表审查的结果,记录了共 932 名接受巴利昔替尼单药治疗的活跃 RA 患者的基线数据和结局。将这些发现与接受该药物联合治疗的共 850 名患者的结果进行了对比。所有分析均为描述性分析,于 2022 年 9 月完成。
在患者登记处和观察性研究中,39.4%-69.6%的患者接受巴利昔替尼单药治疗活跃 RA。在这些患者中,经过大约 6-12 个月的治疗后,根据疾病活动 28 关节计数和临床疾病活动指数的复合指标,分别有 40.7%-93.8%和 55.6%-88.0%的患者达到缓解或低疾病活动。不同研究的治疗持续/停药率有所不同。
这些发现表明,巴利昔替尼单药治疗可能是符合当前指南的 RA 患者常规临床实践中的一种合适治疗选择。