With bimekizumab treatment, the authors noted improvements in joint and skin outcomes, as well as in the composite outcome of minimal disease activity, in the patients in the trial.2 Bimekizumab met the primary (i.e., ACR50 at week 15) and ranked secondary end points (i.e., 1: Health Assessment Questionnaire-Disability Index change from baseline; 2: PASI90; 3: Short Form 36 physical component summary change from baseline; 4: minimal disease activity; and 5: van der Heijde-modified total Sharp score change from baseline). Bimekizumab resulted in inhibition of structural progression in the overall population of patients, as well as in patients with risk factors for progression, such as elevated high sensitivity C-reactive protein (hsCRP) and/or ≥1 bone erosion at baseline.
Dr. McInnes noted the dual inhibition of IL-17F and IL-17A seems to provide efficacy across multiple domains of psoriatic arthritis, perhaps presenting a model for treatment of this disease.
Dr. Ramanan
Baricitinib for Juvenile Idiopathic Arthritis
In the third abstract presentation, Athimalaipet Ramanan, FRCPCH, FRCP, professor, consultant pediatric rheumatologist at Bristol Royal Hospital for Children and Royal National Hospital for Rheumatic Diseases, Bath, England, discussed a phase 3 trial of baricitinib in the treatment of patients with juvenile idiopathic arthritis (JIA).
As many rheumatologists are aware, baricitinib is a Janus kinase 1/2 selective inhibitor approved for the treatment of rheumatoid arthritis. The multi-center, double-blind, efficacy and safety study was divided into three periods: a two-week pharmacokinetic/safety assessment, a 12-week open-label lead-in and an up-to-week 32 double-blind withdrawal period.3
In this study, time of flare was significantly shorter for patients receiving a placebo than for those receiving baricitinib (hazard ratio 0.24 [95% CI 0.13,0.45]; P<0.001). The proportion of patients with a flare was significantly lower for baricitinib vs. placebo (14 [17.1%] vs. 41 [50.6%]; P<0.001). At week 12 in the group of patients receiving baricitinib, 76.3% achieved JIA-ACR30, 63.5% achieved JIA-ACR50, 46.1% achieved JIA-ACR70, and 20.1% achieved JIA-ACR90. When considering the known safety profile of baricitinib in adults with rheumatoid arthritis, no new safety findings of concern were found.
The patients enrolled in this trial were individuals aged 2 to <18 years with extended oligo- or polyarticular JIA, enthesitis-related arthritis or juvenile psoriatic arthritis and an inadequate response to one or more conventional synthetic DMARDs (csDMARDs) and/or bDMARDs. The authors noted that baricitinib may be a potential treatment for such patients.
Dr. Sreekanth
