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Real-world comparative effectiveness and safety of tofacitinib and baricitinib in patients with rheumatoid arthritis

OBJECTIVE: To compare the efficacy and safety of tofacitinib and baricitinib in patients with RA in a real-world setting. METHODS: A total of 242 patients with RA who were treated with tofacitinib (n = 161) or baricitinib (n = 81) were enrolled. We evaluated efficacy and safety between tofacitinib a...

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Autores principales: Iwamoto, Naoki, Sato, Shuntaro, Kurushima, Shota, Michitsuji, Toru, Nishihata, Shinya, Okamoto, Momoko, Tsuji, Yoshika, Endo, Yushiro, Shimizu, Toshimasa, Sumiyoshi, Remi, Suzuki, Takahisa, Okada, Akitomo, Koga, Tomohiro, Kawashiri, Shin-ya, Fujikawa, Keita, Igawa, Takashi, Aramaki, Toshiyuki, Ichinose, Kunihiro, Tamai, Mami, Nakamura, Hideki, Mizokami, Akinari, Origuchi, Tomoki, Ueki, Yukitaka, Eguchi, Katsumi, Kawakami, Atsushi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8299678/
https://www.ncbi.nlm.nih.gov/pubmed/34301311
http://dx.doi.org/10.1186/s13075-021-02582-z
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author Iwamoto, Naoki
Sato, Shuntaro
Kurushima, Shota
Michitsuji, Toru
Nishihata, Shinya
Okamoto, Momoko
Tsuji, Yoshika
Endo, Yushiro
Shimizu, Toshimasa
Sumiyoshi, Remi
Suzuki, Takahisa
Okada, Akitomo
Koga, Tomohiro
Kawashiri, Shin-ya
Fujikawa, Keita
Igawa, Takashi
Aramaki, Toshiyuki
Ichinose, Kunihiro
Tamai, Mami
Nakamura, Hideki
Mizokami, Akinari
Origuchi, Tomoki
Ueki, Yukitaka
Eguchi, Katsumi
Kawakami, Atsushi
author_facet Iwamoto, Naoki
Sato, Shuntaro
Kurushima, Shota
Michitsuji, Toru
Nishihata, Shinya
Okamoto, Momoko
Tsuji, Yoshika
Endo, Yushiro
Shimizu, Toshimasa
Sumiyoshi, Remi
Suzuki, Takahisa
Okada, Akitomo
Koga, Tomohiro
Kawashiri, Shin-ya
Fujikawa, Keita
Igawa, Takashi
Aramaki, Toshiyuki
Ichinose, Kunihiro
Tamai, Mami
Nakamura, Hideki
Mizokami, Akinari
Origuchi, Tomoki
Ueki, Yukitaka
Eguchi, Katsumi
Kawakami, Atsushi
author_sort Iwamoto, Naoki
collection PubMed
description OBJECTIVE: To compare the efficacy and safety of tofacitinib and baricitinib in patients with RA in a real-world setting. METHODS: A total of 242 patients with RA who were treated with tofacitinib (n = 161) or baricitinib (n = 81) were enrolled. We evaluated efficacy and safety between tofacitinib and baricitinib using multivariable analyses to avoid confounding. Their clinical disease activity and AEs were evaluated for 24 weeks. RESULTS: The mean (SD) DAS28-ESR change from baseline to 24 weeks was 1.57 (1.55) (tofacitinib) and 1.46 (1.36) (baricitinib). There was no significant difference in the clinical response between the two groups (adjusted mean difference, 0.04; 95% CI, −0.35 to 0.28). The efficacy was not significantly changed in the patients without concomitant MTX use in both groups, but the concomitant MTX use showed better clinical efficacy in the cases of baricitinib treatment. In both groups, the most common AE was herpes zoster infection, and the AE rates were similar between the two groups. However, the predictive factors contributing to clinical response as revealed by a multivariable logistic analysis differed. The concomitant oral steroid use was independently associated with the achievement of DAS-low disease activity in the tofacitinib group, whereas in the baricitinib group, the number of biological and/or targeted synthetic DMARDs previously used was associated. CONCLUSIONS: Our findings indicate that tofacitinib and baricitinib had comparable continuing efficacies and safety profiles. However, there is a possibility that the influence of clinical characteristics on the treatment response differs. The comparison provides useful information to the optimal use of JAK inhibitors in real-world settings. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13075-021-02582-z.
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spelling pubmed-82996782021-07-28 Real-world comparative effectiveness and safety of tofacitinib and baricitinib in patients with rheumatoid arthritis Iwamoto, Naoki Sato, Shuntaro Kurushima, Shota Michitsuji, Toru Nishihata, Shinya Okamoto, Momoko Tsuji, Yoshika Endo, Yushiro Shimizu, Toshimasa Sumiyoshi, Remi Suzuki, Takahisa Okada, Akitomo Koga, Tomohiro Kawashiri, Shin-ya Fujikawa, Keita Igawa, Takashi Aramaki, Toshiyuki Ichinose, Kunihiro Tamai, Mami Nakamura, Hideki Mizokami, Akinari Origuchi, Tomoki Ueki, Yukitaka Eguchi, Katsumi Kawakami, Atsushi Arthritis Res Ther Research Article OBJECTIVE: To compare the efficacy and safety of tofacitinib and baricitinib in patients with RA in a real-world setting. METHODS: A total of 242 patients with RA who were treated with tofacitinib (n = 161) or baricitinib (n = 81) were enrolled. We evaluated efficacy and safety between tofacitinib and baricitinib using multivariable analyses to avoid confounding. Their clinical disease activity and AEs were evaluated for 24 weeks. RESULTS: The mean (SD) DAS28-ESR change from baseline to 24 weeks was 1.57 (1.55) (tofacitinib) and 1.46 (1.36) (baricitinib). There was no significant difference in the clinical response between the two groups (adjusted mean difference, 0.04; 95% CI, −0.35 to 0.28). The efficacy was not significantly changed in the patients without concomitant MTX use in both groups, but the concomitant MTX use showed better clinical efficacy in the cases of baricitinib treatment. In both groups, the most common AE was herpes zoster infection, and the AE rates were similar between the two groups. However, the predictive factors contributing to clinical response as revealed by a multivariable logistic analysis differed. The concomitant oral steroid use was independently associated with the achievement of DAS-low disease activity in the tofacitinib group, whereas in the baricitinib group, the number of biological and/or targeted synthetic DMARDs previously used was associated. CONCLUSIONS: Our findings indicate that tofacitinib and baricitinib had comparable continuing efficacies and safety profiles. However, there is a possibility that the influence of clinical characteristics on the treatment response differs. The comparison provides useful information to the optimal use of JAK inhibitors in real-world settings. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13075-021-02582-z. BioMed Central 2021-07-23 2021 /pmc/articles/PMC8299678/ /pubmed/34301311 http://dx.doi.org/10.1186/s13075-021-02582-z Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Iwamoto, Naoki
Sato, Shuntaro
Kurushima, Shota
Michitsuji, Toru
Nishihata, Shinya
Okamoto, Momoko
Tsuji, Yoshika
Endo, Yushiro
Shimizu, Toshimasa
Sumiyoshi, Remi
Suzuki, Takahisa
Okada, Akitomo
Koga, Tomohiro
Kawashiri, Shin-ya
Fujikawa, Keita
Igawa, Takashi
Aramaki, Toshiyuki
Ichinose, Kunihiro
Tamai, Mami
Nakamura, Hideki
Mizokami, Akinari
Origuchi, Tomoki
Ueki, Yukitaka
Eguchi, Katsumi
Kawakami, Atsushi
Real-world comparative effectiveness and safety of tofacitinib and baricitinib in patients with rheumatoid arthritis
title Real-world comparative effectiveness and safety of tofacitinib and baricitinib in patients with rheumatoid arthritis
title_full Real-world comparative effectiveness and safety of tofacitinib and baricitinib in patients with rheumatoid arthritis
title_fullStr Real-world comparative effectiveness and safety of tofacitinib and baricitinib in patients with rheumatoid arthritis
title_full_unstemmed Real-world comparative effectiveness and safety of tofacitinib and baricitinib in patients with rheumatoid arthritis
title_short Real-world comparative effectiveness and safety of tofacitinib and baricitinib in patients with rheumatoid arthritis
title_sort real-world comparative effectiveness and safety of tofacitinib and baricitinib in patients with rheumatoid arthritis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8299678/
https://www.ncbi.nlm.nih.gov/pubmed/34301311
http://dx.doi.org/10.1186/s13075-021-02582-z
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