Naoki Iwamoto1, Shuntaro Sato2, Shota Kurushima3, Toru Michitsuji3, Shinya Nishihata3, Momoko Okamoto3, Yoshika Tsuji3, Yushiro Endo3, Toshimasa Shimizu3, Remi Sumiyoshi3, Takahisa Suzuki4, Akitomo Okada5, Tomohiro Koga3,6, Shin-Ya Kawashiri3,7, Keita Fujikawa8, Takashi Igawa3, Toshiyuki Aramaki9, Kunihiro Ichinose3, Mami Tamai3, Hideki Nakamura3, Akinari Mizokami8, Tomoki Origuchi10, Yukitaka Ueki9, Katsumi Eguchi9, Atsushi Kawakami3. 1. Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. naoki-iwa@nagasaki-u.ac.jp. 2. Clinical Research Center, Nagasaki University Hospital, Nagasaki, Japan. 3. Department of Immunology and Rheumatology, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. 4. Department of Rheumatology, Sasebo City General Hospital, Sasebo, Japan. 5. Department of Rheumatology, Japanese Red Cross Nagasaki Genbaku Hospital, Nagasaki, Japan. 6. Center for Bioinformatics and Molecular Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. 7. Departments of Community Medicine, Division of Advanced Preventive Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. 8. Department of Rheumatology, Japan Community Healthcare Organization, Isahaya General Hospital, Isahaya, Japan. 9. Department of Rheumatology, Sasebo Chuo Hospital, Sasebo, Japan. 10. Department of Physical Therapy, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
Abstract
OBJECTIVE: To compare the efficacy and safety of tofacitinib and baricitinib in patients with RA in a real-world setting. METHODS: A total of 242 patients with RA who were treated with tofacitinib (n = 161) or baricitinib (n = 81) were enrolled. We evaluated efficacy and safety between tofacitinib and baricitinib using multivariable analyses to avoid confounding. Their clinical disease activity and AEs were evaluated for 24 weeks. RESULTS: The mean (SD) DAS28-ESR change from baseline to 24 weeks was 1.57 (1.55) (tofacitinib) and 1.46 (1.36) (baricitinib). There was no significant difference in the clinical response between the two groups (adjusted mean difference, 0.04; 95% CI, -0.35 to 0.28). The efficacy was not significantly changed in the patients without concomitant MTX use in both groups, but the concomitant MTX use showed better clinical efficacy in the cases of baricitinib treatment. In both groups, the most common AE was herpes zoster infection, and the AE rates were similar between the two groups. However, the predictive factors contributing to clinical response as revealed by a multivariable logistic analysis differed. The concomitant oral steroid use was independently associated with the achievement of DAS-low disease activity in the tofacitinib group, whereas in the baricitinib group, the number of biological and/or targeted synthetic DMARDs previously used was associated. CONCLUSIONS: Our findings indicate that tofacitinib and baricitinib had comparable continuing efficacies and safety profiles. However, there is a possibility that the influence of clinical characteristics on the treatment response differs. The comparison provides useful information to the optimal use of JAK inhibitors in real-world settings.
OBJECTIVE: To compare the efficacy and safety of tofacitinib and baricitinib in patients with RA in a real-world setting. METHODS: A total of 242 patients with RA who were treated with tofacitinib (n = 161) or baricitinib (n = 81) were enrolled. We evaluated efficacy and safety between tofacitinib and baricitinib using multivariable analyses to avoid confounding. Their clinical disease activity and AEs were evaluated for 24 weeks. RESULTS: The mean (SD) DAS28-ESR change from baseline to 24 weeks was 1.57 (1.55) (tofacitinib) and 1.46 (1.36) (baricitinib). There was no significant difference in the clinical response between the two groups (adjusted mean difference, 0.04; 95% CI, -0.35 to 0.28). The efficacy was not significantly changed in the patients without concomitant MTX use in both groups, but the concomitant MTX use showed better clinical efficacy in the cases of baricitinib treatment. In both groups, the most common AE was herpes zoster infection, and the AE rates were similar between the two groups. However, the predictive factors contributing to clinical response as revealed by a multivariable logistic analysis differed. The concomitant oral steroid use was independently associated with the achievement of DAS-low disease activity in the tofacitinib group, whereas in the baricitinib group, the number of biological and/or targeted synthetic DMARDs previously used was associated. CONCLUSIONS: Our findings indicate that tofacitinib and baricitinib had comparable continuing efficacies and safety profiles. However, there is a possibility that the influence of clinical characteristics on the treatment response differs. The comparison provides useful information to the optimal use of JAK inhibitors in real-world settings.
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Authors: Eun Bong Lee; Roy Fleischmann; Stephen Hall; Bethanie Wilkinson; John D Bradley; David Gruben; Tamas Koncz; Sriram Krishnaswami; Gene V Wallenstein; Chuanbo Zang; Samuel H Zwillich; Ronald F van Vollenhoven Journal: N Engl J Med Date: 2014-06-19 Impact factor: 91.245
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Authors: Andrei Barbulescu; Johan Askling; Katerina Chatzidionysiou; Helena Forsblad-d'Elia; Alf Kastbom; Ulf Lindström; Carl Turesson; Thomas Frisell Journal: Rheumatology (Oxford) Date: 2022-10-06 Impact factor: 7.046