Characterization and changes of lymphocyte subsets in baricitinib-treated patients with rheumatoid arthritis: an integrated analysis

Tanaka, Y. et al. (2018) Characterization and changes of lymphocyte subsets in baricitinib-treated patients with rheumatoid arthritis: an integrated analysis. Arthritis and Rheumatology, 70(12), pp. 1923-1932. (doi:10.1002/art.40680) (PMID:30058112)

Tanaka, Y. et al. (2018) Characterization and changes of lymphocyte subsets in baricitinib-treated patients with rheumatoid arthritis: an integrated analysis. Arthritis and Rheumatology, 70(12), pp. 1923-1932. (doi:10.1002/art.40680) (PMID:30058112)

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Abstract

Objective: Baricitinib is an oral selective inhibitor of Janus kinase (JAK) 1 and JAK2 that is efficacious in patients with rheumatoid arthritis (RA). This study analyzed changes in lymphocyte cell subsets during baricitinib treatment and correlated such changes with clinical outcomes of baricitinib treatment. Methods: An integrated analysis was conducted by pooling data from three completed Phase 3 trials comparing placebo and baricitinib treatment (RA‐BEAM, RA‐BUILD, and RA‐BEACON) and one ongoing long‐term extension study (RA‐BEYOND) in patients (N=2,186) with active RA. Results: Baricitinib treatment was associated with an early transient increase in total lymphocyte count at week 4, which returned to baseline by week 12. Up to week 104, transient changes within normal reference ranges in T cells and subsets were observed with baricitinib treatment. B cells and relevant subpopulations increased after 4 weeks of baricitinib treatment with no further increases noted through 104 weeks of treatment. Natural killer (NK) cells transiently increased after 4 weeks of baricitinib treatment, before decreasing below baseline levels and then stabilizing over time. Few correlations were observed between changes in lymphocyte subsets and clinical endpoints with baricitinib treatment, and most were also observed within the placebo arm. A modest potential association was observed for baricitinib 4‐mg between low NK cells and treatment emergent infections but not serious infections or herpes zoster. Conclusion: Overall, changes in lymphocyte subsets were largely within normal reference ranges across the baricitinib Phase 3 RA clinical program, and were not associated with increased risk of serious infections.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McInnes, Professor Iain
Authors: Tanaka, Y., McInnes, I. B., Taylor, P. C., Byers, N. L., Chen, L., de Bono, S., Issa, M., Macias, W. L., Rogai, V., Rooney, T. P., Schlichting, D. E., Zuckerman, S. H., and Emery, P.
College/School:College of Medical Veterinary and Life Sciences > Institute of Infection Immunity and Inflammation
Journal Name:Arthritis and Rheumatology
Publisher:Wiley
ISSN:2326-5191
ISSN (Online):2326-5205
Published Online:29 July 2018
Copyright Holders:Copyright © 2018 Eli Lilly and Company. Arthritis & Rheumatology published by Wiley Periodicals, Inc. on behalf of American College of Rheumatology
First Published:First published in Arthritis and Rheumatology 70(12): 1923-1932
Publisher Policy:Reproduced under a Creative Commons License

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