Abstract
Patients with rheumatoid arthritis (RA) may experience residual pain and functional impairment despite good control of disease activity. This study compared improvements in pain and physical function in patients with well-controlled RA after 24 weeks’ treatment with baricitinib, adalimumab or placebo in the 52-week RA-BEAM phase III study. Adults with active RA and inadequate response to methotrexate received baricitinib 4 mg once daily, adalimumab 40 mg every two weeks or placebo, with background methotrexate. Patients (N = 1010) were categorised as in remission, in remission or low disease activity, or not in remission or low disease activity at week 24. For patients in remission or low disease activity (n = 310), improvements in mean pain and physical function scores at week 24 were significantly greater with baricitinib than placebo (p < 0.001 and p < 0.01, respectively) and adalimumab (p < 0.05 for both). For both outcomes, differences between adalimumab and placebo were not significant. The proportions of patients in remission or low disease activity with minimal or no pain and with normalised physical function were numerically greater with baricitinib than placebo. Baricitinib 4 mg once daily provided enhanced improvement in pain and physical function in patients with well-controlled RA, suggesting it may produce effects beyond immunomodulation.
Highlights
A major goal in the contemporary treatment of rheumatoid arthritis (RA) is to achieve remission or low disease activity, with the aim of reducing inflammation to prevent joint damage and physical disability [1,2]
Baricitinib is an oral selective inhibitor of Janus kinase (JAK)1 and JAK2 [11], which are essential for the intracellular signalling of various cytokines associated with inflammation in RA [12,13]
Characteristics were similar across the treatment groups, including the proportions taking steroids and/or concomitant conventional synthetic disease-modifying antirheumatic drugs
Summary
A major goal in the contemporary treatment of rheumatoid arthritis (RA) is to achieve remission or low disease activity, with the aim of reducing inflammation to prevent joint damage and physical disability [1,2]. Achieving this objective target is not always associated with a corresponding improvement in disability (Health Assessment Questionnaire (HAQ)) scores and other patient-reported outcomes (PROs): In a study of the Leiden Early Arthritis Clinic cohort, for example, patients with. The efficacy and safety of baricitinib as a treatment for RA were established in four phase III, randomised, double-blind, multicentre studies in patients with active disease [17,18,19,20]
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