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Structural damage progression in patients with early rheumatoid arthritis treated with methotrexate, baricitinib, or baricitinib plus methotrexate based on clinical response in the phase 3 RA-BEGIN study

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  1. Imaging of Common Rheumatic Joint Diseases Affecting the Upper Limbs

    Research output: Contribution to journalReviewResearchpeer-review

  2. Adjustment of the multi-biomarker disease activity score to account for age, sex and adiposity in patients with rheumatoid arthritis

    Research output: Contribution to journalJournal articleResearchpeer-review

  3. The need for comparative data in spondyloarthritis

    Research output: Contribution to journalJournal articleResearchpeer-review

  • Désirée van der Heijde
  • Patrick Durez
  • Georg Schett
  • Esperanza Naredo
  • Mikkel Østergaard
  • Gabriella Meszaros
  • Francesco De Leonardis
  • Inmaculada de la Torre
  • Pedro López-Romero
  • Douglas Schlichting
  • Eric Nantz
  • Roy Fleischmann
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The objective of this study was to evaluate structural damage progression based on clinical response in rheumatoid arthritis patients with no or limited prior disease-modifying anti-rheumatic drug treatment receiving the Janus kinase (JAK)1/JAK2 inhibitor baricitinib 4 mg, methotrexate (MTX), or the combination. Data from the phase 3 RA-BEGIN study were analysed post hoc. Proportions of patients with structural damage progression (change from baseline greater than the smallest detectable change in modified total Sharp score) at week 52 were evaluated based on sustained Disease Activity Score for 28-joint count with serum high-sensitivity C-reactive protein (DAS28-hsCRP) ≤ 3.2 or Simplified Disease Activity Index (SDAI) score ≤ 11; no formal statistical comparisons between treatments were performed to test these proportions. Baseline factors associated with risk of structural damage progression, including Clinical Disease Activity Index (CDAI) score, were identified using multivariate analysis. Patients achieving versus not achieving sustained DAS28-hsCRP ≤ 3.2 or SDAI score ≤ 11 were less likely to experience structural damage progression at week 52. In patients achieving these responses, structural damage progression was less likely with baricitinib monotherapy or plus MTX than with MTX monotherapy. In patients not achieving these sustained clinical thresholds, structural damage progression was less likely with baricitinib plus MTX than with either monotherapy. Independent of treatment, baseline factors significantly associated with increased risk of structural damage progression included higher hsCRP and CDAI score, smoking, female sex, and lower body mass index. In conclusion, patients achieving versus not achieving sustained DAS28-hsCRP ≤ 3.2 or SDAI score ≤ 11 were less likely to show structural damage progression, irrespective of treatment.

Original languageEnglish
JournalClinical Rheumatology
Volume37
Issue number9
Pages (from-to)2381-2390
Number of pages10
ISSN0770-3198
DOIs
Publication statusPublished - Sep 2018

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