In a nutshell
This study investigated the patient reported outcomes (PRO) in patients receiving baricitinib (Olumiant) and methotrexate (Trexall).
They found that patients receiving baricitinib had greater improvement in PRO compared to methotrexate alone.
Some background
Rheumatoid arthritis (RA) is an autoimmune disease where the body’s immune system attacks healthy joint tissue and causes irreversible damage. Treatment strategies aim to reduce the immune response. Standard first line treatment for many patients is methotrexate (MTX), however, not all patients respond well to MTX.
Baricitinib is a new medication for the treatment of RA. It reduces inflammation by blocking the activity of the Janus kinase (JAK, a protein) pathway, which is thought to contribute to RA. Studies have shown that baricitinib may be superior to MTX in reducing inflammation. Patient reported outcomes (PRO) are an important consideration in assessing the effectiveness of a drug.
Methods & findings
This study compares PRO in patients receiving baricitinib or MTX.
584 patients with rheumatoid arthritis were included in this study. Patients were randomly assigned to one of three groups: MTX (10-20mg, once weekly), baricitinab (4 mg, once daily), or combination treatment. Patients were asked to complete a number of health self-assessments over the course of one year. Some of the parameters examined included pain, fatigue, health-related quality of life and activity impairment.
Patients receiving baricitinab, either alone or combined with MTX, had greater improvements in PROs compared to MTX alone. This included improvements in joint pain, health-related quality of life and fatigue. Work productivity was also increased in patients receiving baricitinib compared to MTX alone.
The bottom line
This study concluded that baricitinib treatment results in greater improvement in patient-related ouctomes compared to methotrexate alone.
The fine print
Patients in this study had not previously taken disease-modifying anti-rheumatic drugs (DMARDs). In clinical practice, most patients will have been prescribed DMARDs if methotrexate is not working well. This means that baricitinab may not be superior to other DMARDs.
What’s next?
If you have any concerns regarding anti-rheumatic drugs, please discuss with your doctor.
Published By :
Arthritis Research & Therapy
Date :
Sep 18, 2017
