Patient-reported outcomes of Baricitinib in patients with rheumatoid arthritis and no or limited prior disease-modifying antirheumatic drug treatment

Disease-modifying anti-rheumatic drugs (DMARDs), especially Methotrexate (MTX) are the topmost treatment regimen for rheumatoid arthritis (RA). But, they have been shown to mitigate joint damage and inflammation. Therefore, RA-BEGIN study demonstrated that Baricitinib alone or in combination with MTX, showed significant improvement as compared to MTX.

The analysis estimates Baricitinib's patient-reported outcomes (PROs) as monotherapy or combined with Methotrexate (MTX) among RA individuals with no or minimum previous traditional synthetic disease-modifying antirheumatic drugs (DMARDs) and naïve to biological DMARDs.

A total of 159 participants received 4 mg Baricitinib once daily, 210 obtained MTX administered once weekly and 215 obtained combination of Baricitinib and MTX. PROs involved EuroQol 5-Dimensions (EQ-5D) Health State Profile, worst tiredness, patient's assessment of pain, Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA), duration of morning joint stiffness (MJS), Acute (SF-36), Health Assessment Questionnaire-Disability Index (HAQ-DI), the Patient’s Global Assessment of Disease Activity (PtGA),  worst joint pain, Short Form 36 version 2,  and Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F). Logistic regression models and analysis of covariance (ANCOVA) were performed to assess the comparisons. 

Participants involved in both Baricitinib groups exhibited greater improvement (p ≤ 0.01) in pain, worst joint pain, fatigue, HAQ-DI, SF-36 physical component score,  EQ-5D, and PtGA at 24th and 52nd week as compared to the MTX. For the SF-36 mental component score, participants of both Baricitinib groups presented statistically notable improvements at the 52nd week as compared to MTX-treated patients. Further for WPAI-RA, Baricitinib groups showed statistically significant improvements than MTX at week 24 and Baricitinib + MTX at week 52.

Baricitinib in uniting with MTX or singly, when employed as initial therapy, appeared in notable improvement than MTX in the various pre-specified PRO measures.