Baricitinib in rheumatoid arthritis-interstitial lung disease: national multicenter study of 72 patients and literature review.

IF 4.7 2区医学 Q1 RHEUMATOLOGY

Rheumatology Pub Date : 2025-06-10 DOI:10.1093/rheumatology/keaf314

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 Cervantes Perez, 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

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引用次数: 0

Abstract

Objective: To assess the effectiveness and safety of baricitinib (BARI) in Rheumatoid Arthritis-interstitial lung disease (RA-ILD) in clinical practice.

Methods: : National multicentre retrospective study of 72 RA-ILD patients treated with BARI. We analyzed the following outcomes at baseline and at 3, 6, 12, 18, 24 months, and last follow-up: a) dyspnea (modified Medical Research Council scale), b) forced vital capacity (FVC), c) diffusing capacity of the lungs for carbon monoxide (DLCO), d) chest high resolution computed tomography (HRCT), e) arthritis activity (DAS28-ESR), and f) corticosteroid-sparing effect. Additionally, we analyzed safety data and performed a literature review up to now.

Results: We included 72 patients (52 women; mean age 68 ± 10 years). All patients had received disease-modifying antirheumatic drugs (DMARDs). Median ILD duration up to BARI initiation was of 25 [13-63] months. 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 DMARDs in 29 (40%). Mean baseline values of FVC and DLCO (% pred.) were 86 ± 28 and 69 ± 20, respectively. After a median [IQR] follow-up of 32 [13-65] months dyspnea, FVC, DLCO, HRCT improved/stabilized in 90%, 88%, 65%, 72%, respectively. Mean DAS28-ESR improved from 4.29-2.99. and 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.

查看原文本刊更多论文

Baricitinib治疗类风湿关节炎-间质性肺病：72例患者的国家多中心研究和文献综述。

目的：评价巴西替尼（baricitinib， BARI）治疗类风湿关节炎-间质性肺疾病（RA-ILD）的临床疗效和安全性。方法：对72例接受BARI治疗的RA-ILD患者进行全国多中心回顾性研究。我们分析了基线、3、6、12、18、24个月和最后一次随访时的以下结果：a)呼吸困难（修改后的医学研究委员会量表），b)用力肺活量（FVC）， c)肺部一氧化碳弥散量（DLCO）， d)胸部高分辨率计算机断层扫描（HRCT）， e)关节炎活动性（DAS28-ESR）， f)皮质类固醇节约效果。此外，我们分析了迄今为止的安全性数据并进行了文献综述。结果：我们纳入了72例患者(女性52例；平均年龄68±10岁)。所有患者均接受了改善疾病的抗风湿药（DMARDs）治疗。到BARI开始时ILD的中位持续时间为25[13-63]个月。最常见的ILD类型为间质性肺炎(n = 33；49%)和非特异性间质性肺炎(n = 22；32%)。43例（60%）患者采用BARI单药治疗，29例（40%）患者采用常规DMARDs联合治疗。FVC和DLCO的平均基线值（% pred）分别为86±28和69±20。中位[IQR]随访32[13-65]个月后，呼吸困难、FVC、DLCO、HRCT改善/稳定的比例分别为90%、88%、65%、72%。平均DAS28-ESR从4.29-2.99改善。泼尼松的中位剂量从5 mg/天降至2.5 mg/天。相关不良事件不常见。结论：BARI可能是治疗RA-ILD患者肺部和关节疾病的有效且安全的替代方法，即使在难治性病例中也是如此。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Rheumatology 医学-风湿病学

CiteScore

9.40

自引率

7.30%

发文量

1091

审稿时长

2 months

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.