Baricitinib in Patients with Refractory Rheumatoid Arthritis
Mark C. Genovese,Joel M. Kremer,Omid Zamani,Charles Ludivico,Marek Krogulec,Li Xie,Scott D. Beattie,Alisa E. Koch,Tracy Cardillo,Terence Rooney,William L. Macias,Stephanie de Bono,Douglas E Schlichting,Josef S. Smolen +13 more
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TLDR
In patients with rheumatoid arthritis and an inadequate response to biologic DMARDs, baricitinib at a daily dose of 4 mg was associated with clinical improvement at 12 weeks and a small reduction in neutrophil levels and increases in serum creatinine and low-density cholesterol levels.Abstract:
BackgroundIn phase 2 studies, baricitinib, an oral Janus kinase 1 and 2 inhibitor, reduced disease activity in patients with rheumatoid arthritis who had not previously received treatment with biologic disease-modifying antirheumatic drugs (DMARDs). MethodsIn this phase 3 study involving 527 patients with an inadequate response to or unacceptable side effects associated with one or more tumor necrosis factor inhibitors, other biologic DMARDs, or both, we randomly assigned the patients in a 1:1:1 ratio to baricitinib at a dose of 2 or 4 mg daily or placebo for 24 weeks. End points, tested hierarchically at week 12 to control type 1 error, were the American College of Rheumatology 20% (ACR20) response (primary end point), the Health Assessment Questionnaire–Disability Index (HAQ-DI) score, the 28-joint Disease Activity Score based on C-reactive protein level (DAS28-CRP), and a Simplified Disease Activity Index (SDAI) score of 3.3 or less (on a scale of 0.1 to 86.0, with a score of 3.3 or less indicating rem...read more
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EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2016 update
Josef S Smolen,Robert Landewé,Ferdinand C. Breedveld,Maya H Buch,Maya H Buch,Gerd R Burmester,Maxime Dougados,Paul Emery,Paul Emery,Cécile Gaujoux-Viala,Laure Gossec,Jackie L Nam,Jackie L Nam,Sofia Ramiro,Kevin L. Winthrop,Maarten de Wit,Daniel Aletaha,Neil Betteridge,Johannes W. J. Bijlsma,Maarten Boers,Frank Buttgereit,Bernard Combe,Maurizio Cutolo,Nemanja Damjanov,Johanna M. W. Hazes,Marios Kouloumas,Tore K Kvien,Xavier Mariette,Karel Pavelka,Piet L. C. M. van Riel,Andrea Rubbert-Roth,Marieke Scholte-Voshaar,David Scott,T. Sokka-Isler,John B. Wong,Désirée van der Heijde +35 more
TL;DR: These recommendations intend informing rheumatologists, patients, national rheumology societies, hospital officials, social security agencies and regulators about EULAR's most recent consensus on the management of RA, aimed at attaining best outcomes with current therapies.
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Diagnosis and Management of Rheumatoid Arthritis: A Review.
Daniel Aletaha,Josef S Smolen +1 more
TL;DR: A treat-to-target strategy aimed at reducing disease activity by at least 50% within 3 months and achieving remission or low disease activity within 6 months, with sequential drug treatment if needed, can prevent RA-related disability.
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JAK inhibition as a therapeutic strategy for immune and inflammatory diseases.
Daniella M. Schwartz,Yuka Kanno,Alejandro V. Villarino,Michael E. Ward,Massimo Gadina,John J. O'Shea +5 more
TL;DR: The biology of JAKs is discussed from a translational perspective, focusing on recent insights from clinical trials, the development of novel agents and the use of jakinibs in a spectrum of immune and inflammatory diseases.
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Immunopathogenesis of Rheumatoid Arthritis
TL;DR: Recent data that support intriguing models of disease pathogenesis allude to the possibility of restoration of immunologic homeostasis and thus a state of tolerance associated with drug-free remission of RA, and represents a bold vision for the future of RA therapeutics.
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Novel treatment strategies in rheumatoid arthritis
Gerd R Burmester,Janet E. Pope +1 more
TL;DR: New insights into the management of rheumatoid arthritis with targeted therapy approaches using classic and novel medications are described, and the potential effects of precision medicine in this challenging disease are outlined.
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