AB0258 Impact of controlling disease activity on regaining normal physical function, and achieving no or limited pain in patients with rheumatoid arthritis treated with baricitinib
Authors: K. de Vlam, B. Fautrel, M. van de Laar, B.W. Kirkham, R. Alten, K.V. Beneden, F. de Leonardis, P. Lopez-Romero, C. Gaich, A. Quebe, A. Cardoso, R. Fleischmann, P. Emery
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background</h3> Remission or low disease activity (LDA) are the recommended treatment (tx) targets in rheumatoid arthritis (RA).<sup>1</sup> It is still unknown whether achieving remission/LDA is associated with normalisation of physical function, and limiting pain. <h3>Objectives</h3> To describe the impact of baricitinib (BARI) tx on regaining normal physical function, and achieving no/limited pain in patients (pts) who achieved remission or LDA, or remained in moderate or high disease activity (MDA, HDA). <h3>Methods</h3> This is a post-hoc analysis of RA-BEAM (NCT01710358) and RA-BEGIN (NCT01711359). Mutually exclusive categories were defined as clinical disease activity index (CDAI) scores of ≤2.8 (remission),&gt;2.8 to≤10 (LDA),&gt;10 to≤22 (MDA), and &gt;22 (HDA). Last observation carried forward was used for pain visual analogue scale (0–100 mm VAS) and Health Assessment Questionnaire-Disability Index (HAQ-DI) to impute missing values. Descriptive analyses of the pts achieving normalisation of physical function was defined by a HAQ-DI score of &lt;0.5 (normative value), and limited/no pain by pain VAS of ≤10 mm at week (wk) 12 and 24 as a function of disease activity. <h3>Results</h3> Overall, 1228 pts in RA-BEAM (448, PBO+MTX; 471, BARI +MTX; 309, ADA +MTX) and 543 pts in RA-BEGIN (190, MTX; 156, BARI; 197, BARI +MTX) were included. In RA-BEAM, among pts in remission at wk 12,% pts achieving limited/no pain was numerically higher in BARI (83%; 33/40) group compared with ADA (73%; 16/22) and PBO (67%; 6/9); at wk 24, these percentages were 81% (61/75), 82% (32/39), and 63% (12/19) for BARI, ADA, and PBO, respectively. Among pts who achieved remission on BARI +MTX tx, normal physical function was reported in 65% (26/40) and 73% (55/75) of pts at wk 12 and 24, respectively (Fig 1). For ADA +MTX treated pts, the proportion was 73% (16/22) at wk 12% and 69% (27/39) at wk 24. In RA-BEGIN, among pts in remission,% pts with limited/no pain at wk 12 was numerically higher for BARI (96%; 21/22) compared with BARI +MTX (82%; 32/39) or MTX (64%; 9/14); limited/no pain at wk 24, was reported in 68% (23/34), 87% (40/46), and 77% (17/22) of pts treated with BARI, BARI +MTX, and MTX, respectively. Among pts in remission,% pts achieving normal HAQ-DI at wk 12 and 24 with BARI monotherapy were 91% (20/22) and 82% (28/34); BARI +MTX, 77% (30/39) and 91% (42/46); and MTX monotherapy, 79% (11/14) and 82% (18/22), respectively. Percentages indicate the pts who regained normal physical functions (HAQ&lt;0.5), and less/no pain (pain VAS≤10 mm) with different disease activities (CDAI scores of≤2.8 [remission], 2.8≤10 [LDA], 10 to≤22 [MDA], and&gt;22 [HDA]) in different treatment groups *In RA-BEAM, MTX was given as a background therapy among all treatment groups. <h3>Conclusions</h3> These data support that controlling the disease activity by achieving remission or LDA increases the chances to regain normal physical function and relieve pain, independent of the tx. The data from RA-BEAM may indicate that achieving limited/no pain at wk 12 may be more likely with BARI vs ADA, when being in remission. <h3>Reference</h3> [1] Smolen JS, et al. Ann Rheum Dis. Jun 2017;76(6):960–977. <h3>Disclosure of Interest</h3> K. de Vlam Consultant for: Eli Lilly and Company, B. Fautrel Grant/research support from: AbbVie, MSD, Pfizer, Consultant for: AbbVie, Biogen, BMS, Celgene, Janssen, Lilly, Medac, MSD, NORDIC Pharma, Novartis, Pfizer, Roche, Sanofi-Aventis, SOBI, UCB, M. van de Laar Grant/research support from: Abbvie, Janssen, Eli Lilly and Company, MSD, Pfizer, BMS, Consultant for: Janssen, Eli Lilly and Company, MSD, Pfizer, Sanofi, Novartis, B. Kirkham Grant/research support from: Arthritis Research UK, Abbvie, Eli Lilly and Company, Roche, UCB, Consultant for: Abbvie, Celgene, Eli Lilly and Company Janssen, Novartis, Pfizer, R. Alten Speakers bureau: Eli Lilly and Company, K. V. Beneden Employee of: Eli Lilly and Company, F. de Leonardis Employee of: Eli Lilly and Company, P. Lopez-Romero Employee of: Eli Lilly and Company, C. Gaich Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, A. Quebe Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, A. Cardoso Shareholder of: Eli Lilly and Company, Employee of: Eli Lilly and Company, R. Fleischmann Grant/research support from: AbbVie, Amgen, AstraZeneca, Bristol-Myers Squibb, Celgene, Genetech, GlaxoSmithKline, Janssen, Eli Lilly and Company, Merck, Pfizer, Regeneron, Roche, Sanofi, Aventis, UCB, Consultant for: AbbVie, Akros, Amgen, Bristol-Myers Squibb, Celgene, Genentech, GSK, Janssen, Eli Lilly and Company, Pfizer, Sanofi-Aventis, UCB, P. Emery Consultant for: Pfizer, MSD, Abbvie, BMS, UCB, Roche, Novartis, Samsung, Sandoz, Eli Lilly and Company