AB0442 RESPONSE TO BARICITINIB IN PATIENTS WITH RHEUMATOID ARTHRITISWITH FAILURE TO CONVENTIONAL SYNTHETIC DMARD AND/OR BIOLOGICAL DMARD: DATA FROM A LOCAL REGISTRY
Authors: Jose Rosas, José Miguel Senabre-Gallego, Gregorio Santos Soler, José Antonio Bernal-Vidal, Esteban Salas-Heredia, Ana Pons, Catalina Cano, Estíbaliz Ivars, José Alberto García-Gómez, Xavier Barber
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Objectives</h3> To know the characteristics of patients with rheumatoid arthritis (RA), in treatment with baricitinib (BARI), who have failed to conventional synthetic DMARD (DMARDcs) and/or biological DMARDs (DMARD). <h3>Methods</h3> Prospective observational study, in real life, of patients with RA, under treatment with BARI. General data of the patients, (age, gender, comorbidity), RA and treatment were collected (time of evolution, presence of RF and ACPA, efficacy indexes at the beginning of BARI and the last visit: DAS28-VSG and CDAI, previous or concomitant treatment with DMARDcs and/or DMARDb, end of treatment and cause, time in BARI, serious adverse effects during treatment with BARI. <h3>Results</h3> Of 529 patients in follow-up, who have received at least one dose of DMARDb, 224 (42%) are diagnosed with RA, and 58 (26%) of them receive some drug inhibitor of the JAK pathway; 40/224 (18%) of them BARI. The patients treated with BARI, 77% were women, mean age of 58.95 ± 10.8 years and mean evolution of RA of 9.6 ± 8.8 years. The mean BMI is 28.8 ± 1.8. The FR and ACPA are positive at 86% and 89%, respectively. 94% of patients continued concomitant treatment with some DMARDcs. BARI is the first drug after failure of DMARDcs (F1) in 24/40 (60%) patients, and in 16/40 (40%), after failure to some DMARDb: second drug after failure to DMARDb (F2) in 2 (6%), third (F3) in 5 (13%) patients, fourth (F4) in 6 patients (17%) and fifth (F5) in 3 (9%) patients. The mean global time in BARI is 9.6 ± 3.2 months, being for F1, F2, F3, F4, F5, of 7, 5.2, 7.7, 6.9 and 11.1 months, respectively. BARI patients, such as F1 versus F2-F5, presented significantly higher BMI (30.83 ± 2.6 vs. 26.95 ± 4.4, p &lt;001), higher percentage of ACPA (100% vs. 74%, P = 0.026), and lower mean time of evolution of RA (5.3 years, range: 0.7-25 vs 14.75 years, range: 2-36 years, p &lt;0.001). In patients F2-F5, patients had failed to some DMARDb before initiating BARI, in F2 to 1 therapeutic target, in F3 to 2 targets and in F4 and F5 to 2 or 3 targets. Regarding safety, 1 patient presented herpes zoster. The results of clinical efficacy with DAS28-VSG and baseline CDAI and in the last evaluation are shown in the table. <h3>Conclusion</h3> 1. Baricitinib is effective and safe in real clinical practice. 2. It is competent of achieving clinical remission or low activity, in a high percentage of patients, even in those who have failed several biological drugs or several therapeutic targets previously. <h3>Acknowledgement</h3> The study was supported with a research grant from the Association for Research in Rheumatology of Marina Baixa (AIRE-MB) <h3>Disclosure of Interests</h3> Jose Rosas Consultant for: Abbvie, Amgen, Bristol, Janssen, Lilly, Merck Sharp &amp; Dohme, Pfizer, UCB Pharma, Speakers bureau: Abbvie, Amgen, Bristol, Janssen, Lilly, Merck Sharp &amp; Dohme, Pfizer, UCB Pharma, José Miguel Senabre-Gallego: None declared, Gregorio Santos Soler: None declared, José Antonio Bernal-Vidal: None declared, Esteban Salas-Heredia: None declared, Ana Pons: None declared, Catalina Cano: None declared, Estíbaliz Ivars: None declared, José Alberto García-Gómez: None declared, Xavier Barber: None declared