Patients with rheumatoid arthritis (RA) have a heterogeneous response to common therapies. Moreover, wider use of tumor necrosis factor (TNF) inhibitors, such as adalimumab, has shown many patients have inadequate responses to or are intolerant to these agents. In such cases, rheumatologists either add an additional disease-modifying anti-rheumatic drug (DMARD) or switch the patient from one DMARD to another. Such a change may be reasonable for patients who exhibit a suboptimal clinical response to a TNF inhibitor. But first, rheumatologists must consider if a patient should undergo a washout period, which is the time between ending the initial treatment and starting a new treatment to ensure the initial drug is out of the patient’s system. Because adalimumab, for example, has a mean circulating half-life of approximately 14 days, a washout period lasts for weeks.
The results from the phase 3, RA-BEAM study show RA patients who are switched from adalimumab to baricitinib experience improvements in disease control even in the absence of an adalimumab washout. Yoshiya Tanaka, MD, PhD, professor and chair of the First Department of Internal Medicine, School of Medicine at the University of Occupational and Environmental Health, Japan, and colleagues found study patients also experienced improvements in physical function and pain during the initial 12 weeks after the switch.
