THU0194 CHARACTERISATION OF DEPTH OF RESPONSE, INCLUDING 50% IMPROVEMENT IN ACR COMPONENTS AT WEEK 12 AND REMISSION AT WEEK 24, FOLLOWING TREATMENT WITH FILGOTINIB COMPARED WITH METHOTREXATE OR ADALIMUMAB IN PATIENTS WITH RHEUMATOID ARTHRITIS
Authors: G. R. Burmester, D. Aletaha, J. Pope, Y. Tanaka, P. Durez, A. Gomez-Centeno, A. Pechonkina, B. Bartok, F. Matzkies, L. Ye, Z. Yin, R. Besuyen, W. Rigby, B. Combe
Journal: Annals of the Rheumatic Diseases (2020)

Background: The oral, potent, selective JAK1 inhibitor filgotinib (FIL) showed favorable efficacy at week (W)12 and W24 of treatment for rheumatoid arthritis (RA) compared with methotrexate (MTX) monotherapy (mono) in FINCH 3 ( NCT02886728 ) and with placebo (PBO) or adalimumab (ADA) in FINCH 1 ( NCT02889796 ). Objectives: 50% clinical improvement from baseline at W12 is a key checkpoint for RA treatment. 1 These post hoc analyses evaluated FIL treatment effect on improvement in ACR components at W12 and remission at W24 in FINCH 3 and FINCH 1. Methods: FINCH 3 and FINCH 1 were global, phase 3, double-blind studies in patients (pts) with active RA. In FINCH 3, MTX-naïve pts were randomised 2:1:1:2 to once-daily (QD) oral FIL 200 mg + weekly MTX, FIL 100 mg + MTX, FIL 200 mg mono + PBO, or PBO + MTX mono up to W52. In FINCH 1, pts with inadequate response to MTX (MTX-IR) on a background of stable MTX were randomised (3:3:2:3) to oral FIL 200 or 100 mg QD, subcutaneous ADA 40 mg Q2W, or PBO up to W52. Post hoc analyses evaluated proportions of pts with 50% improvement from baseline in each ACR component and in all 7 ACR components (ACR50c) at W12, and proportions of pts with ACR50c at W12 achieving clinical remission at W24. Comparisons between treatments were not adjusted for multiplicity; subgroup comparisons are descriptive. Results: Analyses included 1249 pts in FINCH 3 and 1755 pts in FINCH 1. Greater proportions of pts receiving FIL 200 mg + MTX, FIL 100 mg + MTX, or FIL mono (FINCH 3) vs MTX mono (FINCH 3) or PBO + MTX (FINCH 1)—and numerically higher proportions of pts receiving FIL 200 mg + MTX vs FIL 100 mg + MTX (both studies) or ADA + MTX (FINCH 1)—achieved ACR50c and individual components at W12 ( Table ). Proportions of pts achieving CDAI ≤2.8 (Figure 1) or Boolean remission (Figure 2) at W24 were higher for pts with vs without ACR50c at W12 (Figures 1–2). Table. Proportions of patients with 50% improvement in each ACR component and ACR50c at week 12 ACR component SJC66 TJC68 Pain PGA SGA HAQ-DI hsCRP ACR50c FINCH 3 FIL 200 mg + MTX 82.2 *** 76.9 *** 59.2 *** 72.8 *** 56.5 *** 54.9 *** 59.1 *** 26.2 *** FIL 100 mg + MTX 81.2 *** 74.4 *** 48.5 * 68.1 * 46.9 ** 49.5 *** 58.5 *** 19.3 *** FIL 200 mg mono 82.9 *** 75.7 *** 47.6 * 66.2 * 47.1 ** 47.3 ** 59.5 *** 22.9 *** MTX mono 67.1 59.6 39.2 58.4 35.6 35.6 33.7 6.0 FINCH 1 FIL 200 mg + MTX 83.2 ***,+ 77.9 ***,+ 50.1 ***,+ 67.4 *** 48.2 *** 42.1 ***,+ 67.2 ***,+++ 18.5 *** FIL 100 mg + MTX 77.9 *** 72.3 *** 45.1 *** 62.9 *** 43.2 *** 35.2 *** 55.0 *** 12.5 *** ADA + MTX a 76.9 70.5 41.5 61.5 42.0 34.4 55.7 13.8 PBO + MTX 66.7 59.2 28.0 50.9 28.0 23.1 25.9 2.5 a Not formally compared vs PBO + MTX. * , p &lt;0.05; ** , p &lt;0.01; *** , p &lt;0.001 vs MTX mono (FINCH 3) or PBO + MTX (FINCH 1); + , p &lt;0.05; +++ , p &lt;0.001 vs ADA + MTX (FINCH 1); not adjusted for multiplicity. ACR50c, 50% improvement from baseline in all ACR components; ADA, adalimumab; FIL, filgotinib; MTX, methotrexate; mono, monotherapy; PBO, placebo. Conclusion: In MTX-naïve and MTX-IR pts with RA, FIL treatment was more effective vs MTX (FINCH 3) or PBO (FINCH 1) for achieving ACR50c at W12—a potential predictor of remission at W24. Proportions of pts achieving ACR50c at W12 were numerically higher for pts receiving FIL 200 mg + MTX vs FIL 100 mg + MTX (both studies) or ADA + MTX (FINCH 1). References: [1]Smolen JS, et al. Ann Rheum Dis . 2017;76:960–77. Disclosure of Interests: Gerd Rüdiger Burmester Consultant of: AbbVie Inc, Eli Lilly, Gilead, Janssen, Merck, Roche, Pfizer, and UCB Pharma, Speakers bureau: AbbVie Inc, Eli Lilly, Gilead, Janssen, Merck, Roche, Pfizer, and UCB Pharma, Daniel Aletaha Grant/research support from: AbbVie, Novartis, Roche, Consultant of: AbbVie, Amgen, Celgene, Lilly, Medac, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi Genzyme, Speakers bureau: AbbVie, Celgene, Lilly, Merck, Novartis, Pfizer, Sanofi Genzyme, UCB, Janet Pope Grant/research support from: AbbVie, Bristol-Myers Squibb, Eli Lilly &amp; Company, Merck, Roche, Seattle Genetics, UCB, Consultant of: AbbVie, Actelion, Amgen, Bayer, Boehringer Ingelheim, Bristol-Myers Squibb, Eicos Sciences, Eli Lilly &amp; Company, Emerald, Gilead Sciences, Inc., Janssen, Merck, Novartis, Pfizer, Roche, Sandoz, Sanofi, UCB, Speakers bureau: UCB, Yoshiya Tanaka Grant/research support from: Asahi-kasei, Astellas, Mitsubishi-Tanabe, Chugai, Takeda, Sanofi, Bristol-Myers, UCB, Daiichi-Sankyo, Eisai, Pfizer, and Ono, Consultant of: Abbvie, Astellas, Bristol-Myers Squibb, Eli Lilly, Pfizer, Speakers bureau: Daiichi-Sankyo, Astellas, Chugai, Eli Lilly, Pfizer, AbbVie, YL Biologics, Bristol-Myers, Takeda, Mitsubishi-Tanabe, Novartis, Eisai, Janssen, Sanofi, UCB, and Teijin, Patrick Durez Speakers bureau: AbbVie, Bristol-Myers Squibb, Celltrion, Eli Lilly, Pfizer, Sanofi, Antonio Gomez-Centeno: None declared, Alena Pechonkina Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Beatrix Bartok Shareholder of: Gilead Sciences Inc., Employee of: Gilead Sciences Inc., Franziska Matzkies Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Lei Ye Shareholder of: Gilead Sciences Inc., Employee of: Gilead Sciences Inc., Zhaoyu Yin Shareholder of: Gilead Sciences, Inc., Employee of: Gilead Sciences, Inc., Robin Besuyen Shareholder of: Galapagos, Employee of: Galapagos, William Rigby Grant/research support from: Bristol-Myers Squibb, Consultant of: AbbVie, Bristol-Myers Squibb, Genentech, Pfizer, Bernard Combe Grant/research support from: Novartis, Pfizer, Roche-Chugai, Consultant of: AbbVie; Gilead Sciences, Inc.; Janssen; Eli Lilly and Company; Pfizer; Roche-Chugai; Sanofi, Speakers bureau: Bristol-Myers Squibb; Gilead Sciences, Inc.; Eli Lilly and Company; Merck Sharp &amp; Dohme; Pfizer; Roche-Chugai; UCB