AB0291 SHORT TERM EFFECTIVENESS OF JANUS KINASE INHIBITORS AND BIOLOGIC DRUGS IN RHEUMATOID ARTHRITISPATIENTS FROM THE APULIAN REGISTRY BIUOPURE
Authors: Carmelo Zuccaro, Leonardo Santo, Laura Quarta, Nicola Maruotti, Giorgio Carlino, Romano Bucci, Angelo Semeraro, Antonio Marsico, Daniela Mazzotta, Paola Chiara Francesca Falappone, Florenzo Iannone
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Randomized clinical trials have provided evidence that janus kinase inhibitors (Jak-i) induce a quick response in patients affected with rheumatoid arthritis (RA), especially in terms of perception of pain. However, a few data are available on this issue in RA patients upon treatment with Jak-i in the settings of real life. <h3>Objectives</h3> We aimed at evaluating the early clinical response in RA patients treated with Jak-i or biologic disease modifying drugs (bDMARDs) from the Apulian registry BIOPURE. <h3>Methods</h3> We retrospectively evaluated patients with RA, according to 2010 ACR/EULAR Criteria, who begun Jak-i or biologic drugs from December 2017 (since baricitinib was available onto the market) through December 2018. We included 189 patients (female 146, 77.25%) with age (mean ±SD) of 57.8 ±12 years. Of them, 143 (75.6%) were treated with bDMARDs, whereas 46 (24.3%) were on JAK Inhibitors, namely baricitinib or tofacitinib (Table 1). Disease activity score on 28 joints (DAS28) and reported pain on a 0-100 visual analogue scale (VAS) were estimated at baseline, 3 and 6 months. Intra-group changes from baseline of DAS28 and VAS-pain was assessed by t-test. Mean difference changes in VAS-pain at 3 months between Jak-i and bDMARDs were compared by t-test. Possible predictors of the achievement of EULAR good-response at 3 months were estimated by binary logistic multiple regression analysis. <h3>Results</h3> Considering the whole cohort, mean DAS28 at baseline was 3.70 (±1.4) and significantly decreased to 2.76 (±1.1) at 3-months (p&lt;0.001) and to 2.99 (±1.4) at 6-months (p&lt;0.001). Likewise, VAS-pain was significantly improved from baseline, either at 3 and 6 months (p&lt;0.001). Also VAS-pain significantly decreased in patients on treatment with Jak-i (3 months p=0.0001, 6 months p=0.008) and bDMARDs (3 months p=0.0001, 6 months p=0.009). Of note, mean difference from baseline of VAS pain at 3 months was significantly higher in patients treated with JAK-i than in those on bDMARDs (p=0.0005) (Figure 1). An EULAR good response was reached by 37.5% at 3 months and by 56.4% of patients at 6 months. In particular, patients with JAK Inhibitors met this goal at 3 months significantly more frequently than others (p=0.003). EULAR good response at 3 months was strongly associated with Jak-i treatment (OR 3.1, 95%CI 1.4-6.6). <h3>Conclusion</h3> Despite the usual flaws of the analysis from registries, such as comorbidities, concomitant therapies, adherence, different disease activity or line of treatment, our study suggests that Jak-i allow to achieve an early clinical benefit in terms of patient reported pain at greater extent than classical bDMARDs in real-world. <h3>Disclosure of Interests</h3> Carmelo Zuccaro Consultant for: C Zuccaro has received consultancy fees and/or speaker honoraria from MSD, AbbVie, Novartis, Pfizer, Janssen outside this work, Speakers bureau: C Zuccaro has received consultancy fees and/or speaker honoraria from MSD, AbbVie, Novartis, Pfizer, Janssen outside this work, Leonardo Santo Consultant for: L Santo has received consultancy fees and/or speaker honoraria from AbbVie, MSD, Novartis UCB outside this work, Speakers bureau: L Santo has received consultancy fees and/or speaker honoraria from AbbVie, MSD, Novartis UCB outside this work, Laura Quarta: None declared, Nicola Maruotti Speakers bureau: N Maruotti has received speaker honoraria from Pfizer outside this work, Giorgio Carlino Consultant for: G Carlino had has received consultancy fees from Pfizer, Janssen, AbbVie, MSD, BMS., Romano Bucci Consultant for: R Bucci has received consultancy fees and/or speaker honoraria from Pfizer, Sanofi, MSD, BMS, Speakers bureau: R Bucci has received consultancy fees and/or speaker honoraria from Pfizer, Sanofi, MSD, BMS, Angelo Semeraro Speakers bureau: A Semeraro has received speaker honoraria from Sanofi, Roche, AbbVie, BMS, MSD, Novartis, Antonio Marsico: None declared, Daniela Mazzotta: None declared, Paola Chiara Francesca Falappone Consultant for: PC Falappone had received consultancy fees and/or speaker honoraria from Amgen, Abbott, MSD, BMS, outside this work, Speakers bureau: PC Falappone had received consultancy fees and/or speaker honoraria from Amgen, Abbott, MSD, BMS, outside this work, Florenzo Iannone Consultant for: F Iannone has received consultancy fees and/or speaker honoraria from Pfizer, AbbVie, MSD, BMS, Novartis, Lilly, UCB outside this work, Speakers bureau: F Iannone has received consultancy fees and/or speaker honoraria from Pfizer, AbbVie, MSD, BMS, Novartis, Lilly, UCB outside this work