A new study published in the journal Rheumatology and Therapy examined the effect of baricitinib on Rheumatoid Arthritis (RA) patients who have had an inadequate to their methotrexate therapy.

Methotrexate and Baricitinib

Methotrexate is a csDMARDs which is the go-to treatment in China. It is efficacious and is low in cost. But, time has shown its not as great as it was originally cracked up to be. Approximately half of patients who experience a flare after stopping this medication are not able to to achieve remission again.

Further, some patients do not experience the improved quality of life that others do. Additionally, progressive joint damage is not effectively stopped for all patients.

Baricitinib is a Janus Kinase Inhibitor that researchers believe may be efficacious for patients who have not been responsive to methotrexate. To examine such, they conducted a placebo-controlled, randomized, and double-blind trial.

The Study

This study included 231 RA patients who had moderate or severe disease and who had an inadequate response to their methotrexate treatment.

The study lasted 52 weeks. There were no safety concerns documented.

All patients were randomized to receive either the treatment or placebo. Those in the treatment group received 4mg of baricitinib once each day.

The primary outcome was the measure of ACR20 response at week 12. Also evaluated were

• ACR50
• ACR70
• Patient reported pain
• Disease activity
• Remission
• Mean severity and duration of joint stiffness in the morning
• Low disease activity rates
• Worse tiredness
• Worse joint pain

The team found that at week 12, the patients in the treatment group had much better response when compared to placebo. Their response rate was 53.4% compared to just 22.6% in the placebo group. Similar improvements were also found in the secondary outcomes for the treatment group.

Perhaps most importantly, baricitinib was not found to have differing efficacy for patients of different demographic characteristics or different baseline characteristics.

The results of this trial showing baricitinib’s effectiveness and tolerability is extremely positive for this patient community. Hopefully we will see more updates on this investigative therapy soon.

You can read more about this trial here.