Efficacy and safety of different Janus kinase inhibitors combined with methotrexate for the treatment of rheumatoid arthritis: a single-center randomized trial

Advances in Rheumatology

Research

Fang Qin¹  Wanling Wei¹  Wen Zeng¹  Fei Dong¹  Xiaoling Liao¹  Ling Lei¹  Wang Huo² 

[1]Department of Rheumatology and Immunology, The First Affiliated Hospital of Guangxi Medical University, 530000, Nanning, Guangxi Province, China

[2]Department of Rheumatology, Liu Zhou People’s Hospital, Guangxi, China

关键词: Rheumatoid arthritis;    Baricitinib;    Tofacitinib;    Janus kinase (JAK) inhibitors;    Disease Activity Scale-28 (DAS-28);   

DOI  :  10.1186/s42358-023-00331-1

 received in 2023-04-03, accepted in 2023-10-06,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectiveTo compare the efficacy and safety between baricitinib (BARI) and tofacitinib (TOFA) for the treatment of the rheumatoid arthritis (RA) patients receiving methotrexate (MTX) in clinical practice.MethodsThis retrospective study recruited 179 RA patients treated with BARI (2–4 mg/d) or TOFA (10 mg/d) at The First Affiliated Hospital of Guangxi Medical University from September 2019 to January 2022. The rate of low disease activity (LDA) was used as the primary end point. Secondary end points included the Disease Activity Scale-28 (DAS-28)-C-reactive protein (CRP); the rate of DAS28-CRP remission; visual analogue scale (VAS) for pain, swollen joint, and tender joint counts; and adverse events at the 6-month follow-up. Several factors affecting LDA achievement were also analyzed.ResultsSeventy-four patients were treated with BARI and 105 were treated with TOFA, including 83.24% females, with a median (IQR) age of 56.0 (53.0–56.0) years old and disease duration of 12.0 (6.0–12.0) months. There was no difference of the rate of LDA between the BARI and TOFA treatment groups. All disease indices in the two groups were significantly improved, including a significantly lower VAS in the BARI group (P < 0.05), reflecting the drug efficacy after 1 and 6 months of treatment. The incidence of adverse reactions was similar in these two groups.ConclusionThe treatment efficacy and safety of BARI and TOFA in the RA patients were similar, but BARI was more effective in pain relief than TOFA. An older baseline age was more likely to achieve LDA in the BARI group, while a low baseline erythrocyte sedimentation rate (ESR) was more likely to achieve LDA in the TOFA group.

【 授权许可】

CC BY   
© Sociedade Brasileira de Reumatologia 2023

【 图 表 】

Fig. 2

Fig. 6

Fig. 1