gms | German Medical Science

Introduction: Baricitinib (BARI) is a Janus kinase (JAK1/2) inhibitor approved for the treatment of adults with moderate-to-severe rheumatoid arthritis (RA). RA-BE-REAL is a prospective, multinational, observational study, evaluating time until discontinuation following either BARI, biologic disease-modifying antirheumatic drugs ((b)DMARDs) or any other targeted synthetic (ts) DMARDs treatment.

Objective: To characterize the characteristics, treatment patterns, effectiveness, and discontinuation rates of patients with RA from German hospitals participating in RA-BE-REAL study at 24-months.

Methods: Two patient cohorts were evaluated: initiated treatment with BARI (cohort A), or any other b/tsDMARDs (cohort B). Disease activity was assessed by clinical disease activity index (CDAI), physician function by Health Assessment Questionnaire Disability Index (HAQ-DI) and pain by Visual Analogue Scale (VAS). Descriptive analysis was employed. Time to discontinuation and discontinuation rates were estimated descriptively.

Results: This analysis involved 422 (cohort A; N=240 and cohort B; N=182) RA patients. At baseline mean age and percentage of females was similar across cohorts. Cohort A mean disease duration (standard deviation) of 8.4 (7.2) years was longer than in cohort B 7.7 (9.2). At baseline CDAI, HAQ-DI and pain VAS were similar across cohorts. More patients in cohort A (47.9%) were previously treated with b/tsDMARDs than in cohort B (33.0%). 10.0% of patients from cohort A and 12.6% in cohort B received >2 b/tsDMARDs. Monotherapy was more frequent in cohort A patients (61.3% vs 45.6%). At 24-months, 46.9% (cohort A) vs. 50.4% (cohort B) of the patients achieved low disease activity (CDAI <10) and 25.0% vs 20.2% achieved remission (CDAI ≤2.8), respectively. Fewer patients in cohort A discontinued treatment at 24-months - 50 (20.8%) and 72 (39.6%) patients from cohorts A and B respectively. The most common reasons for discontinuation were primary non-response (cohort A; n=11 (4.6%) and cohort B; n=26 (14.3%)) and secondary loss of response (cohort A; n=14 (5.8%) and cohort B; n=21 (11.5%)).

Conclusion: Despite patients receiving BARI (cohort A) being older, with longer disease duration and more frequent use of b/tsDMARDs, fewer discontinuations were observed than in cohort B at 24-months.

Disclosures: Rieke Alten reports consulting fees from: Abbvie, Amgen, BMS, Celltrion, Chugai, Galapagos, Gilead, Janssen, Lilly, Mylan/Viatris, Novartis, Pfizer, Roche, USB, payment/honoraria from: bbvie, Amgen, BMS, Celltrion, Chugai, Galapagos, Gilead, Janssen, Lilly, Mylan/Viatris, Novartis, Pfizer, Roche, USB and support for attending meetings/travel from: Abbvie, Amgen, BMS, Celltrion, Chugai, Galapagos, Gilead, Janssen, Lilly, Mylan/Viatris, Novartis, Pfizer, Roche, USB. Gerd-Rudiger Burmester reports support for medical writing from Lilly; consulting fees from: Abbvie, Lilly, Pfizer, Galapagos and payment/honoraria from: Abbvie, Lilly and Galapagos. Silke Zinke payments/fees: Abbvie, Astra-Zeneca, Galapagos, GSK, Jannsen, Lilly, Novartis, UCB. Maren Sieburg reports payment/fees from: AbbVie, Amgen, Biogen, BMS, Boehringer Ingelheim, Celltrion, Galapagos, Hexal, Janssen, Lilly, Medac, MSD, Novartis, Pfizer, Roche, Sanofi-Aventis, UCB. Katrin Riegel, Angela Kill, Jen Gerwien and Samuel Ogwu are employees and minor shareholders of Eli Lilly and Company. Klaus Krüger reports consulting fees paid to him from Lilly; payment/honoraria for speaking from Lilly.

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