Baricitinib Versatile and Effective in Rheumatoid Arthritis

Rheumatoid arthritis patients treated with baricitinib at any point during their treatment, experience improved outcomes, a new clinical trials report shows. (©Vbaleha,AdobeStock.com)

Rheumatoid arthritis patients treated with baricitinib at any point during their treatment, experience improved outcomes, a new clinical trials report shows.

In a study published in a recent Arthritis Care & Research issue, investigators determined patients who either initially receive baricitinib monotherapy, switch to baricitinib monotherapy from methotrexate monotherapy, or add baricitinib to methotrexate, experience sustained or improved disease control.

“Switching to baricitinib monotherapy improved rheumatoid arthritis disease in many patients for whom methotrexate, baricitinib or their combination was their first DMARD regimen,” said study author Ray Fleischmann, M.D., a rheumatologist with the University of Texas Southwestern Medical Cetner. “Many patients achieved acceptable disease control with baricitinib monotherapy. Of those who did not, many responded to the addition of methotrexate.”

To assess the long-term efficacy and safety of baricitinib monotherapy, researchers extended an existing study that looked at the effects of methotrexate monotherapy, baricitinib monotherapy, and baricitinib plus methotrexate therapy by switching all participants to 4 mg baricitinib monotherapy.

According to study results, 4 mg baricitinib treatment and 4 mg baricitinib plus methotrexate produced similar clinical and functional responses. While both therapies performed better than methotrexate alone, radiographic slowing of rheumatoid arthritis was only significant in combination therapy.

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50 percent of patients who either maintained 4 mg baricitinib long term or who switched to 4 mb baricitinib from methotrexate monotherapy, saw an improvement in function and controlling disease activity. Those patients who continued baricitinib monotherapy showed the greatest improvement, researchers said, and those who switched to baricitinib monotherapy from methotrexate monotherapy experienced rapid and pronounced improvement.

Approximately 50 percent of patients experienced an adverse event. The most common were infections and infestations, including the common cold, upper respiratory tract infections, and urinary tract infections.

“These results support that adding baricitinib to methotrexate and, then, considering discontinuing methotrexate if that patient achieves a sustained response may be a reasonable option in patients responding sub-optimally to methotrexate,” Fleischmann said.

REFERENCE:

Fleischmann R, Takeuchi T, Schaffer’s M, et al. “Efficacy and safety of long‐term baricitinib with and without methotrexate for the treatment of rheumatoid arthritis: experience with baricitinib monotherapy continuation or after switching from methotrexate monotherapy or baricitinib plus methotrexate.”Arthritis Care & Research (2019), doi: 10.1002/acr.24007.