Ana Serrano-Combarro, Belén Atienza-Mateo, Adrián Martín-Gutiérrez, Jesús Loarce-Martos, César Antonio Egües Dubuc, Marta Pastor Mena, Rafael B Melero-Gonzalez, María Martín López, Natalia Mena Vázquez, Carmen Carrasco-Cubero, Carolina Pérez García, Andrea García Valle, Gema Bonilla, Juan María Blanco Madrigal, Uxue Astigarraga-Urquia, Nuria Vegas Revenga, Lorena Pérez Albadalejo, Rafaela Ortega Castro, Deseada Palma-Sánchez, Ana María Fernández Ortiz, Patricia López Viejo, María López Lasanta, Marta Garijo Bufort, Ivette Casafont Solé, José Ramón Lamua-Riazuelo, Ignacio Braña Abascal, Virginia Ruiz-Esquide, Evelin Cecilia Cervantes Pérez, Bryan-Josué Flores Robles, María Paz Martínez-Vidal, Juan Moreno Morales, Ana Urruticoechea-Arana, José Rosas, Delia Fernández-Lozano, David Castro Corredor, Iván Ferraz-Amaro, Santos Castañeda, Ricardo Blanco
{"title":"Baricitinib in rheumatoid arthritis-interstitial lung disease: a literature review and national multicentre study of 72 patients.","authors":"Ana Serrano-Combarro, Belén Atienza-Mateo, Adrián Martín-Gutiérrez, Jesús Loarce-Martos, César Antonio Egües Dubuc, Marta Pastor Mena, Rafael B Melero-Gonzalez, María Martín López, Natalia Mena Vázquez, Carmen Carrasco-Cubero, Carolina Pérez García, Andrea García Valle, Gema Bonilla, Juan María Blanco Madrigal, Uxue Astigarraga-Urquia, Nuria Vegas Revenga, Lorena Pérez Albadalejo, Rafaela Ortega Castro, Deseada Palma-Sánchez, Ana María Fernández Ortiz, Patricia López Viejo, María López Lasanta, Marta Garijo Bufort, Ivette Casafont Solé, José Ramón Lamua-Riazuelo, Ignacio Braña Abascal, Virginia Ruiz-Esquide, Evelin Cecilia Cervantes Pérez, Bryan-Josué Flores Robles, María Paz Martínez-Vidal, Juan Moreno Morales, Ana Urruticoechea-Arana, José Rosas, Delia Fernández-Lozano, David Castro Corredor, Iván Ferraz-Amaro, Santos Castañeda, Ricardo Blanco","doi":"10.1093/rheumatology/keaf314","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to assess the effectiveness and safety of baricitinib (BARI) in interstitial lung disease associated with RA (RA-ILD) in clinical practice.</p><p><strong>Methods: </strong>: This was a national multicentre retrospective study of 72 RA-ILD patients treated with BARI. We analysed the following outcomes at baseline and at 3, 6, 12, 18 and 24 months, and at last follow-up: (i) dyspnea (modified Medical Research Council scale), (ii) forced vital capacity (FVC), (iii) diffusing capacity of the lungs for carbon monoxide (DLCO), (iv) chest high-resolution CT (HRCT), (v) arthritis activity (DAS28-ESR), and (vi) CS-sparing effect. Additionally, we analysed the safety data and performed a literature review up to December 2023.</p><p><strong>Results: </strong>We included 72 patients (52 women; mean (s.d.) age 68 (10) years). All patients had received DMARDs. The median [interquartile range (IQR)] ILD duration up to BARI initiation was 25 [13-63] months. The most frequent ILD patterns were usual interstitial pneumonia (n = 33; 49%) and non-specific interstitial pneumonia (n = 22; 32%). BARI was used in monotherapy in 43 (60%) patients and combined with conventional synthetic DMARDs in 29 (40%). Mean (s.d.) baseline values of FVC and DLCO (% predicted) were 86 (28) and 69 (20), respectively. After a median [IQR] follow-up of 32 [13-65] months, dyspnea, FVC, DLCO and HRCT improved or stabilized in 90%, 88%, 65% and 72%, respectively. The mean DAS28-ESR improved from 4.29 to 2.99, and the median prednisone dose was reduced from 5 to 2.5 mg/day. Relevant adverse events were uncommon.</p><p><strong>Conclusion: </strong>BARI may be a useful and safe alternative in both pulmonary and joint disease in RA-ILD patients, even in refractory cases.</p>","PeriodicalId":21255,"journal":{"name":"Rheumatology","volume":" ","pages":"5471-5480"},"PeriodicalIF":4.4000,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Rheumatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/rheumatology/keaf314","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"RHEUMATOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: The objective of this study was to assess the effectiveness and safety of baricitinib (BARI) in interstitial lung disease associated with RA (RA-ILD) in clinical practice.
Methods: : This was a national multicentre retrospective study of 72 RA-ILD patients treated with BARI. We analysed the following outcomes at baseline and at 3, 6, 12, 18 and 24 months, and at last follow-up: (i) dyspnea (modified Medical Research Council scale), (ii) forced vital capacity (FVC), (iii) diffusing capacity of the lungs for carbon monoxide (DLCO), (iv) chest high-resolution CT (HRCT), (v) arthritis activity (DAS28-ESR), and (vi) CS-sparing effect. Additionally, we analysed the safety data and performed a literature review up to December 2023.
Results: We included 72 patients (52 women; mean (s.d.) age 68 (10) years). All patients had received DMARDs. The median [interquartile range (IQR)] ILD duration up to BARI initiation was 25 [13-63] months. The most frequent ILD patterns were usual interstitial pneumonia (n = 33; 49%) and non-specific interstitial pneumonia (n = 22; 32%). BARI was used in monotherapy in 43 (60%) patients and combined with conventional synthetic DMARDs in 29 (40%). Mean (s.d.) baseline values of FVC and DLCO (% predicted) were 86 (28) and 69 (20), respectively. After a median [IQR] follow-up of 32 [13-65] months, dyspnea, FVC, DLCO and HRCT improved or stabilized in 90%, 88%, 65% and 72%, respectively. The mean DAS28-ESR improved from 4.29 to 2.99, and the median prednisone dose was reduced from 5 to 2.5 mg/day. Relevant adverse events were uncommon.
Conclusion: BARI may be a useful and safe alternative in both pulmonary and joint disease in RA-ILD patients, even in refractory cases.
期刊介绍:
Rheumatology strives to support research and discovery by publishing the highest quality original scientific papers with a focus on basic, clinical and translational research. The journal’s subject areas cover a wide range of paediatric and adult rheumatological conditions from an international perspective. It is an official journal of the British Society for Rheumatology, published by Oxford University Press.
Rheumatology publishes original articles, reviews, editorials, guidelines, concise reports, meta-analyses, original case reports, clinical vignettes, letters and matters arising from published material. The journal takes pride in serving the global rheumatology community, with a focus on high societal impact in the form of podcasts, videos and extended social media presence, and utilizing metrics such as Altmetric. Keep up to date by following the journal on Twitter @RheumJnl.