Comparing Baricitinib to Tumor Necrosis Factor Inhibitor in Treating Rheumatoid Arthritis
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Reviewed & Translated by Dat Tien Nguyen, B.A, ScM.
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Posted on August 5th, 2024
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Tumor necrosis factor (TNF) inhibitors and Janus Kinase (JAK) inhibitors are commonly used to treat rheumatoid arthritis; however, TNF inhibitors are often preferred due to their greater availability and lower cost. Consequently, the European Alliance of Associations for Rheumatology endorses the use of TNFi before considering JAK inhibitors. Despite this, JAK inhibitors like baricitinib offer clinical advantages, including a shorter half-life and more convenient administration. To explore these benefits, Eli Lilly sponsored a study comparing baricitinib to TNF inhibitors in the treatment of rheumatoid arthritis.
The study included 199 patients diagnosed with rheumatoid arthritis for a median duration of 2 years. The participants had a baseline average Clinical Disease Activity Index (CDAI) of approximately 20 (on a scale from 0 to 76, with higher scores indicating more severe disease) and an average 28-joint count Disease Activity Score with C-reactive protein (DAS28-CRP) of 4.1 (scores of 3.2-5.1 suggest moderate disease activity). Participants were assigned to either tumor necrosis factor inhibitors (adalimumab, etanercept, golimumab, and infliximab) or baricitinib for 48 weeks; the study did not specify the doses used. By the 12th week of treatment, 42% of the baricitinib group and 20% of the TNF inhibitor group achieved a reduction in disease severity based on the American College of Rheumatology 50 criteria. Additionally, 75% of the baricitinib patients and 46% of the TNFi group achieved disease remission, with a DAS28-CRP score below 2.6. In terms of safety, 3 cases of infections were associated with baricitinib usage.
The study included 199 patients diagnosed with rheumatoid arthritis for a median duration of 2 years. The participants had a baseline average Clinical Disease Activity Index (CDAI) of approximately 20 (on a scale from 0 to 76, with higher scores indicating more severe disease) and an average 28-joint count Disease Activity Score with C-reactive protein (DAS28-CRP) of 4.1 (scores of 3.2-5.1 suggest moderate disease activity). Participants were assigned to either tumor necrosis factor inhibitors (adalimumab, etanercept, golimumab, and infliximab) or baricitinib for 48 weeks; the study did not specify the doses used. By the 12th week of treatment, 42% of the baricitinib group and 20% of the TNF inhibitor group achieved a reduction in disease severity based on the American College of Rheumatology 50 criteria. Additionally, 75% of the baricitinib patients and 46% of the TNFi group achieved disease remission, with a DAS28-CRP score below 2.6. In terms of safety, 3 cases of infections were associated with baricitinib usage.