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4CPS-021 Effectiveness, persistence, and adherence of baricitinib in rheumatoid arthritis: long-term real-world evidence study
  1. A Calvo García1,
  2. E Ramirez Herraiz1,
  3. I Llorente Cubas2,
  4. B Varas de Dios3,
  5. A Morell Baladrón1,
  6. J Benedí González4,
  7. R García de Vicuña2
  1. 1Hospital Universitario de la Princesa, Pharmacy, Madrid, Spain
  2. 2Hospital Universitario de la Princesa, Rheumatology, Madrid, Spain
  3. 3Hospital de Santa Cristina, Rheumatology, Madrid, Spain
  4. 4Universidad Compluetense de Madrid, Farmacology, Madrid, Spain


Background and Importance Baricitinib (BAR) is a Janus kinase inhibitor (JAKi) selective for isoenzymes 1 and 2. It is used in rheumatoid arthritis (RA) with an inadequate response to conventional synthetic disease-modifying drugs (csDMARD).

Aim and Objectives The objective was to evaluate the effectiveness, persistence, and adherence of BAR in RA in a real-world setting.

Material and Methods An ambispective observational study was designed in a third-level hospital. Patients with RA who started BAR between September 2017 and June 2021 were included and signed an informed consent. Patients participating in a clinical trial were excluded. Patients were followed up until December 2021. Effectiveness was evaluated by variation of the Disease Activity Score (28-joint count) using C-reactive protein (DAS28PCR); and by the percentage of patients achieving therapeutic target: low disease activity (LDA) (DAS28CRP≤3.2) or disease remission (DAS28CRP<2.6). Adherence was analysed using the 5 items Compliance-Questionnaire-Rheumatology (CQR5) applied to patients every 6 months, and the medication possession ratio (MPR). The study was approved by the Institutional Review Board of the hospital.

Results 61 patients were included, 51/61 (83.6%) were female. The mean age was 58.1 (15.4) and the mean disease duration was 13.9 (8.3) years. 47/61 (77.0%) and 43/61 (70.5%) patients presented anti-citrullinated protein antibodies and rheumatoid factor, respectively. 44/61 (72.1%) patients had prior exposure to biologic DMARDs. 10/61 (16.4%) patients were on BAR monotherapy. A significant decrease was observed in DAS28PCR from baseline to the end of treatment/follow-up (3.9 (0.9) vs 2.7 (1.3), a difference of 1.2, p=0.000). In addition, 6/61 (9.8%) and 37/61 (60.7%) patients achieved LDA or remission, respectively. 31/61 (50.8%) patients remained on treatment at the end of follow-up, with a median persistence of 31.3 (14.1-47.7) months. The mean MPR was 0.96 (0.08), and all but one patient were adherent (MPR>0,8). According to the CQR5, all patients were ‘good adherers’.

Conclusion and Relevance JAKi are the most recent alternative available for RA treatment. BAR demonstrated effectiveness in our study cohort, with a significant decrease in DAS28PCR, a high percentage of patients reaching the therapeutic target, and a persistence exceeding two years. Adherence to treatment was very high, almost 100%. More studies in real-world setting are needed to confirm these results.

Conflict of Interest No conflict of interest

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