Efficacy of Long-Term Treatment with Once-Daily Baricitinib 2 mg in Patients with Active Rheumatoid Arthritis: Post Hoc Analysis of Two 24-Week, Phase III, Randomized, Controlled Studies and One Long-Term Extension Study.

Arthritis Baricitinib Rheumatoid

Journal

Rheumatology and therapy
ISSN: 2198-6576
Titre abrégé: Rheumatol Ther
Pays: England
ID NLM: 101674543

Informations de publication

Date de publication:
Jun 2021
Historique:
received: 15 02 2021
accepted: 08 05 2021
pubmed: 25 5 2021
medline: 25 5 2021
entrez: 24 5 2021
Statut: ppublish

Résumé

To evaluate long-term efficacy of once-daily baricitinib 2 mg in patients with active rheumatoid arthritis who had an inadequate response (IR) to conventional synthetic disease-modifying antirheumatic drugs (csDMARD) or biologic DMARDs (bDMARD). Data from patients treated with baricitinib 2 mg daily in two 24-week, phase III studies, RA-BUILD (csDMARD-IR; NCT01721057) and RA-BEACON (bDMARD-IR; NCT01721044), and one long-term extension study (RA-BEYOND; NCT01885078), were analyzed (120 weeks). The main outcomes were achievement of low-disease activity (LDA; Simple Disease Activity Index [SDAI] ≤ 11), clinical remission (SDAI ≤ 3.3), Health Assessment Questionnaire Disability Index (HAQ-DI) ≤ 0.5 and improvement from baseline of ≥ 0.22, and safety. Analysis populations included (1) all patients and (2) never-rescued patients. Completer and non-responder imputation (NRI) analyses were conducted on each population. In RA-BUILD, 684 were randomized (229 to baricitinib 2 mg, 180 of whom completed RA-BUILD and entered RA-BEYOND). In RA-BEACON, 527 were randomized (174 to baricitinib 2 mg, 117 of whom completed RA-BEACON and entered RA-BEYOND). In RA-BUILD-BEYOND, 85.1% (63/74, completer) and 27.5% (63/229, NRI) of csDMARD-IR patients treated with baricitinib 2 mg achieved SDAI LDA; 40.5% (30/74, completer) and 13.1% (30/229, NRI) were in SDAI remission; 62.2% (46/74, completer) and 20.1% (46/229, NRI) had HAQ-DI ≤ 0.5 and 81.1% (60/74, completer); and 26.2% (60/229, NRI) achieved ≥ 0.22 change from baseline at week 120. In RA-BEACON-BEYOND, 86.5% (32/37, completer) and 18.4% (32/174, NRI) of bDMARD-IR patients treated with baricitinib 2 mg achieved SDAI LDA; 24.3% (9/37, completer) and 5.2% (9/174, NRI) were in SDAI remission; 50.0% (19/38, completer) and 10.9% (19/174, NRI) had HAQ-DI ≤ 0.5; and 73.7% (28/38, completer) and 16.1% (28/174, NRI) achieved ≥ 0.22 change from baseline at week 120. Rates of adverse events of special interest were consistent with previous reports. Long-term treatment with baricitinib 2 mg demonstrated efficacy for up to 120 weeks and was well tolerated. ClinicalTrials.gov identifier, NCT01721057, NCT01721044, and NCT01885078.

Identifiants

pubmed: 34028703
doi: 10.1007/s40744-021-00317-9
pii: 10.1007/s40744-021-00317-9
pmc: PMC8217400
doi:

Banques de données

ClinicalTrials.gov
['NCT01721057', 'NCT01721044', 'NCT01885078']

Types de publication

Journal Article

Langues

eng

Pagination

987-1001

Références

Smolen J, Steiner G. Therapeutic strategies for rheumatoid arthritis. Nat Rev Drug Discov. 2003;2:473–88.
doi: 10.1038/nrd1109
Colmegna I, Ohata BR, Menard HA. Current understanding of rheumatoid arthritis therapy. Clin Pharmacol Ther. 2012;91:607–20.
doi: 10.1038/clpt.2011.325
Fridman JS, Scherle PA, Collins R, Burn TC, Li Y, Li J, et al. Selective inhibition of JAK1 and JAK2 is efficacious in rodent models of arthritis: preclinical characterization of INCB028050. J Immunol. 2010;184:5298–307.
doi: 10.4049/jimmunol.0902819
Fleischmann R, Schiff M, van der Heijde D, Ramos-Remus C, Spindler A, Stanislav M, et al. Baricitinib, methotrexate, or combination in patients with rheumatoid arthritis and no or limited prior disease-modifying antirheumatic drug treatment. Arthritis Rheumatol. 2017;69:506–17.
doi: 10.1002/art.39953
Taylor PC, Keystone EC, van der Heijde D, Weinblatt ME, del Carmen ML, Gonzaga JR, et al. Baricitinib versus placebo or adalimumab in rheumatoid arthritis. N Engl J Med. 2017;376:652–62.
doi: 10.1056/NEJMoa1608345
Dougados M, van der Heijde D, Chen YC, Greenwald M, Drescher E, Liu J, et al. Baricitinib in patients with inadequate response or intolerance to conventional synthetic DMARDs: results from the RA-BUILD study. Ann Rheum Dis. 2017;76:88–95.
doi: 10.1136/annrheumdis-2016-210094
Genovese MC, Kremer J, Zamani O, Ludivico C, Krogulec M, Xie L, et al. Baricitinib in patients with refractory rheumatoid arthritis. N Engl J Med. 2016;374:1243–52.
doi: 10.1056/NEJMoa1507247
Genovese MC, Smolen JS, Takeuchi T, Burmester G, Brinker D, Rooney TP, et al. Safety profile of baricitinib for the treatment of rheumatoid arthritis over a median of 3 years treatment: an updated integrated safety analysis. Lancet Rheumatol. 2020;2(6):E347–57.
doi: 10.1016/S2665-9913(20)30032-1
Taylor PC, Weinblatt ME, Burmester GR, Rooney TP, Witt S, Walls CD, et al. Cardiovascular safety during treatment with baricitinib in rheumatoid arthritis. Arthritis Rheumatol. 2019;71:1042–55.
doi: 10.1002/art.40841
Buch MH, Silva-Fernandez L, Carmona L, Aletaha D, Christensen R, Combe B, et al. Development of EULAR recommendations for the reporting of clinical trial extension studies in rheumatology. Ann Rheum Dis. 2015;74:963–9.
doi: 10.1136/annrheumdis-2013-204948
Smolen JS, Genovese MC, Takeuchi T, Hyslop DL, Macias WL, Rooney T, et al. Safety profile of baricitinib in patients with active rheumatoid arthritis with over 2 years median time in treatment. J Rheumatol. 2019;46:7–18.
doi: 10.3899/jrheum.171361
Smolen JS, Landewé RBM, Bijlsma JWJ, Burmester GR, Dougados M, Kerschbaumer A. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Ann Rheum Dis. 2019;2020:22.
Bykerk VP, Shadick N, Frits M, Bingham CO III, Jeffery I, Iannaccone C, et al. Flares in rheumatoid arthritis: frequency and management. A report from the BRASS registry. J Rheumatol. 2014;41:227–34.
doi: 10.3899/jrheum.121521
Smolen JS, Breedveld FC, Schiff MH, Kalden JR, Emery P, Eberl G, et al. A simplified disease activity index for rheumatoid arthritis for use in clinical practice. Rheumatology (Oxford). 2003;42:244–57.
doi: 10.1093/rheumatology/keg072
Aletaha D, Nell VP, Stamm T, Uffmann M, Pflugbeil S, Machold K, et al. Acute phase reactants add little to composite disease activity indices for rheumatoid arthritis: validation of a clinical activity score. Arthritis Res Ther. 2005;7:R796-806.
doi: 10.1186/ar1740
Prevoo ML, van ’tHof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL. Modified disease activity scores that include twenty-eight-joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum. 1995;38:44–8.
doi: 10.1002/art.1780380107
Wolfe F, Michaud K, Pincus T. Development and validation of the health assessment questionnaire II: a revised version of the health assessment questionnaire. Arthritis Rheum. 2004;50:3296–305.
doi: 10.1002/art.20549
Ware JE, Sherbourne CD. The MOS 36-Item Short-Form Health Survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30:473–83.
doi: 10.1097/00005650-199206000-00002
van der Heijde D, Landewé RBM, Wollenhaupt J, et al. Assessment of radiographic progression in patients with rheumatoid arthritis treated with tofacitinib in long-term studies. Rheumatology (Oxford). 2020. https://doi.org/10.1093/rheumatology/keaa476 .
doi: 10.1093/rheumatology/keaa476
Cohen SB, Tanaka Y, Mariette X, et al. Long-term safety of tofacitinib up to 9.5 years: a comprehensive integrated analysis of the rheumatoid arthritis clinical development programme. RMD Open. 2020;6(3):e001395.
doi: 10.1136/rmdopen-2020-001395
Álvaro-Gracia JM, García-Llorente JF, Valderrama M, et al. Update on the safety profile of tofacitinib in rheumatoid arthritis from clinical trials to real-world studies: a narrative review. Rheumatol Ther. 2021;8(1):17–40.
doi: 10.1007/s40744-020-00258-9
Nash P, Kerschbaumer A, Dörner T, et al. Points to consider for the treatment of immune-mediated inflammatory diseases with Janus kinase inhibitors: a consensus statement. Ann Rheum Dis. 2021;80(1):71–87.
doi: 10.1136/annrheumdis-2020-218398
El Jammal T, Sève P, Gerfaud-Valentin M, et al. State of the art: approved and emerging JAK inhibitors for rheumatoid arthritis. Expert Opin Pharmacother. 2021;22(2):205–18.
doi: 10.1080/14656566.2020.1822325
Burmester GR, Blanco R, Charles-Schoeman C, et al. Tofacitinib (CP-690,550) in combination with methotrexate in patients with active rheumatoid arthritis with an inadequate response to tumour necrosis factor inhibitors: a randomised phase 3 trial. Lancet. 2013;381:451–60.
doi: 10.1016/S0140-6736(12)61424-X
Cohen SB, Emery P, Greenwald MW, et al. Rituximab for rheumatoid arthritis refractory to anti-tumor necrosis factor therapy: results of a multicenter, randomized, double-blind, placebo-controlled, phase III trial evaluating primary efficacy and safety at 24 weeks. Arthritis Rheum. 2006;54:2793–806.
doi: 10.1002/art.22025
Emery P, Keystone E, Tony HP, et al. IL-6 receptor inhibition with tocilizumab improves treatment outcomes in patients with rheumatoid arthritis refractory to anti-tumour necrosis factor biologicals: results from a 24-week multicentre randomised placebo-controlled trial. Ann Rheum Dis. 2008;67:1516–23.
doi: 10.1136/ard.2008.092932
Genovese MC, Schiff M, Luggen M, et al. Efficacy and safety of the selective co-stimulation modulator abatacept following 2 years of treatment in patients with rheumatoid arthritis and an inadequate response to anti-tumour necrosis factor therapy. Ann Rheum Dis. 2008;67:547–54.
doi: 10.1136/ard.2007.074773
Smolen JS, Aletaha D. Rheumatoid arthritis therapy reappraisal: strategies, opportunities and challenges. Nat Rev Rheumatol. 2015;11:276–89.
doi: 10.1038/nrrheum.2015.8
Smolen JS, Kay J, Doyle MK, et al. Golimumab in patients with active rheumatoid arthritis after treatment with tumour necrosis factor alpha inhibitors (GO-AFTER study): a multicentre, randomised, double-blind, placebo-controlled, phase III trial. Lancet. 2009;374:210–21.
doi: 10.1016/S0140-6736(09)60506-7

Auteurs

Alvin F Wells (AF)

Aurora Rheumatology and Immunotherapy Center, Franklin, WI, USA.

Bochao Jia (B)

Eli Lilly and Company, Lilly Technology Center South, 1555 South Harding Street, Indianapolis, IN, 46221, USA.

Li Xie (L)

Eli Lilly and Company, Lilly Technology Center South, 1555 South Harding Street, Indianapolis, IN, 46221, USA.

Guillermo J Valenzuela (GJ)

Integral Rheumatology and Immunology Specialists, Fort Lauderdale, FL, USA.

Edward C Keystone (EC)

University of Toronto, Toronto, ON, Canada.

Zhanguo Li (Z)

Department of Rheumatology and Immunology, Peking University People's Hospital, Beijing, People's Republic of China.

Amanda K Quebe (AK)

Eli Lilly and Company, Lilly Technology Center South, 1555 South Harding Street, Indianapolis, IN, 46221, USA. amanda.quebe@lilly.com.

Kirstin Griffing (K)

Eli Lilly and Company, Lilly Technology Center South, 1555 South Harding Street, Indianapolis, IN, 46221, USA.

Susan Otawa (S)

Eli Lilly and Company, Lilly Technology Center South, 1555 South Harding Street, Indianapolis, IN, 46221, USA.

Boulos Haraoui (B)

Institut de Rhumatologie de Montréal, Montreal, QC, Canada.

Classifications MeSH