Baricitinib Bested Adalimumab in Rheumatoid Arthritis Trial

In patients with active rheumatoid arthritis symtoms that persisted even though they were taking methotrexate, baricitinib (Lilly/Incyte) treatment led to "significant improvements" researchers reported at the 2015 American College of Rheumatology Annual Meeting in San Francisco, CA.

Peter C. Taylor of the Kennedy Institute of Rheumatology, University of Oxford, Oxford, UK, and colleagues at other institutions said baricitinib improved disease activity in patients who were not responding adequately to conventional synthetic DMARDS, or biologic DMARDS. They conducted a 24-week study of 1,305 patients with RA who were randomized to baricitinib, adalimumab (Humira/AbbVie), or placebo.

The response rate for baricitinib was higher than placebo at week 12. Compared to adalimumab, baricitinib was "superior with respect to measures including ACR20 response and improvement in DAS28-CRP at week 12," they noted.

Compared to placebo, daily diary measures of morning joint stiffness, duration and severity, worst tiredness, and worst joint pain were significant improved in patients receiving baricitinib from as early as week one."

selective JAK1 and JAK2 inhibitor. There are four known JAK enzymes: JAK1, JAK2, JAK3 and TYK2. JAK-dependent cytokines have been implicated in the pathogenesis of a number of inflammatory and autoimmune diseases, suggesting that JAK inhibitors may be useful for the treatment of a broad range of inflammatory conditions.

But two deaths occurred in the group getting baricitinib, one from pneumonia and one from a bleeding duodenal ulcer. Baricitinib is a

The full trial results are available in an abstract presented at the meeting.