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TOPLINE
Among patients with rheumatoid arthritis (RA) who had tried several other treatments, about 69% stayed on baricitinib for a year. Depression and latent tuberculosis infection were associated with an increased risk for baricitinib discontinuation over that period.
METHODOLOGY
- Researchers conducted a prospective, observational study to describe how long patients with RA stayed on baricitinib in routine care and to identify factors linked to discontinuation of the drug.
- They included 135 patients with RA (mean age, 56.1 years; 93.3% women) who initiated baricitinib (4 mg/d) at four rheumatology centers in Greece, with recruitment beginning in March 2022 and lasting 12 months.
- The median duration of disease was 57 months, and baricitinib was the first targeted therapy for only 18.5% of patients.
- Researchers assessed patients every 3 months for up to 12 months, tracking measures including drug retention, disease activity, and adverse events.
TAKEAWAY
- Overall, 68.9% of patients remained on baricitinib at 12 months, with ineffectiveness accounting for 59.5% of discontinuations and side effects for 26.2%.
- Over 12 months, the risk for discontinuation of baricitinib was elevated in patients with depression (adjusted hazard ratio [aHR], 2.715; P = .007) and those with latent tuberculosis infection (aHR, 2.519; P = .020).
- Among patients who stayed on baricitinib beyond 6 months, higher disease activity score in 28 joints (DAS28) at 6 months, hypertension, and latent tuberculosis infection were associated with higher risks for discontinuation (P < .05 for all).
- Mean DAS28 improved significantly at 6 and 12 months (P < .05 for both). A total of 45 patients experienced 62 adverse events (mostly mild or moderate) over 114.67 person-years of follow-up.
IN PRACTICE
"Should these findings be confirmed in other cohorts, a special attention to disease control and specific comorbidities could improve baricitinib use in clinical practice," the authors of the study wrote.
SOURCE
The study was led by Irini Flouri, University of Crete, Heraklion, Greece. It was published online on October 5 in Rheumatology International.
LIMITATIONS
The study lacked a control group and had an observational design, which prevented establishing cause-effect relationships. Several hazard ratios had wide CI values.
DISCLOSURES
No specific funding source was reported. Several authors reported grants, consulting fees, or honoraria from multiple pharmaceutical companies, including AbbVie, Lilly, and Pfizer; for some authors, these were paid through university special accounts for research. One author reported having financial ties with multiple companies unrelated to this study. Detailed disclosures are reported in the original article.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
