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Parisi S, Andrea B, Chiara DM, Alberto LG, Maddalena L, Palma S, Olga A, Massimo R, Marino P, Rosalba C, Elisa V, Rosario F, Giorgio A, Francesco DL, Ylenia DB, Roberta F, Antonella F, Francesco G, Simone B, Dario C, Gerolamo B, Matteo C, Romina A, Natalia M, Giulio F, Patrizia DM, Aldo MC, Veronica F, Francesco MC, Federica L, Gilda S, Carlo S, Marta P, Aurora I, Valeria N, Daniele S, Gianluca L, Adorni G, Eleonora DD, Elena B, Ilaria P, Eugenio A, Alessandra B, Cristina FM, Fabio M, Vincenzo B, Viviana R, Alessia F, Guido R, Rosetta V, Antonio M, Alessandro V, Francesca O, Alarico A, Enrico F. Analysis of survival rate and persistence predictors of baricitinib in real-world data from a large cohort of rheumatoid arthritis patients. CURRENT RESEARCH IN PHARMACOLOGY AND DRUG DISCOVERY 2024; 6:100178. [PMID: 38419949 PMCID: PMC10899020 DOI: 10.1016/j.crphar.2024.100178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 01/23/2024] [Accepted: 02/12/2024] [Indexed: 03/02/2024] Open
Abstract
Objectives The persistence in therapy of rheumatoid arthritis drugs and particularly bDMARD is a limiting factor for their long-term use. The randomized controlled trials (RCTs) may not reflect real-world contexts due to strict inclusion and exclusion criteria. Baricitinib, which targets both JAK1 and JAK2, has been used in Italy for several years. The aim of this multi-center study is to assess the real world persistence on therapy of baricitinib in RA patients and to identify predictive factors of baricitinib's survival rate. Methods This is a retrospective, multicentric, Italian, longitudinal study. All patients were enrolled according to the following criteria: a) age ≥ 18 years old; b) diagnosed with RA according 2010 ACR/EULAR classification criteria; c) treated with baricitinib. In order to describe baricitinib clinical efficacy, the survival rate was evaluated by The Kaplan-Meier curve. Then, predictive factors of drug retention rate were assessed by performing the Cox analysis, identifying which risk factors influenced treatment persistence. Results Overall, we included 478 patients treated with baricitinib. Among them, 380 (79.5%) were females. Baricitinib's survival rate was 94.6% at 6 months, 87.9% at 12 months, 81.7% at 24 months and 53.4% at 48 months. The Cox analysis regression showed that a higher bDMARDs/tsDMARD line of therapy seems to be a negative prognostic factor for the drug retention rate (HR 1.26 CI 95% 1.07-1.49, p = 0.006. Conclusion Real-life study confirms baricitinib effectiveness up to 4 years, but previous treatment with bDMARDs was a negative prognostic factor for its survival rate.
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Affiliation(s)
- Simone Parisi
- Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Rheumatology Unit, Turin, Italy
| | - Becciolini Andrea
- Azienda Ospedaliero-Universitaria di Parma, Department of Medicine, Internal Medicine and Rheumatology Unit, Parma, Italy
| | - Ditto Maria Chiara
- Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Rheumatology Unit, Turin, Italy
| | - Lo Gullo Alberto
- Azienda Ospedaliera di Rilievo Nazionale e di Alta Specializzazione Garibaldi Ospedale Garibaldi-Nesima, Rheumatology Unit, Catania, Italy
| | - Larosa Maddalena
- Azienda Sanitaria Locale 3 Genovese, Division of Rheumatology - Medical Specialties Department, Genoa, Italy
| | - Scolieri Palma
- Ospedale Nuovo Regina Margherita, Internal Medicine and Rheumatology Unit, Rome, Italy
| | - Addimanda Olga
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Department of Internal Medicine-Rheumatology, Bologna, Italy
| | - Reta Massimo
- IRCCS Azienda Ospedaliero-Universitaria di Bologna Policlinico S Orsola, Department of Internal Medicine-Rheumatology, Bologna, Italy
| | - Paroli Marino
- University of Rome La Sapienza, Department of Clinical, Anesthesiological and Cardiovascular Sciences, Polo Pontino, Latina, Italy
| | - Caccavale Rosalba
- University of Rome La Sapienza, Department of Clinical, Anesthesiological and Cardiovascular Sciences, Polo Pontino, Latina, Italy
| | - Visalli Elisa
- Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele Catania, Division of Rheumatology, A.O.U. "Policlinico San Marco", Catania, Italy
| | - Foti Rosario
- Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele Catania, Division of Rheumatology, A.O.U. "Policlinico San Marco", Catania, Italy
| | - Amato Giorgio
- Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele Catania, Division of Rheumatology, A.O.U. "Policlinico San Marco", Catania, Italy
| | - De Lucia Francesco
- Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele Catania, Division of Rheumatology, A.O.U. "Policlinico San Marco", Catania, Italy
| | - Dal Bosco Ylenia
- Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele Catania, Division of Rheumatology, A.O.U. "Policlinico San Marco", Catania, Italy
| | - Foti Roberta
- Azienda Ospedaliero Universitaria Policlinico Vittorio Emanuele Catania, Division of Rheumatology, A.O.U. "Policlinico San Marco", Catania, Italy
| | - Farina Antonella
- ASUR Area Vasta 4 Fermo, Ospedale A Murri, Internal Medicine Unit, Rheumatology outpatient clinic, Fermo, Italy
| | | | - Bernardi Simone
- Morgagni-Pierantoni Hospital, Rheumatology Unit, Forlì, Italy
| | - Camellino Dario
- Azienda Sanitaria Locale 3 Genovese, Division of Rheumatology - Medical Specialties Department, Genoa, Italy
| | - Bianchi Gerolamo
- Azienda Sanitaria Locale 3 Genovese, Division of Rheumatology - Medical Specialties Department, Genoa, Italy
| | - Colina Matteo
- Azienda USL di Imola, Department of Internal Medicine and Oncology. Service of Rheumatology, Imola, Italy
- University of Bologna, Department of Biomedical and Neuromotor Sciences, Imola, Italy
| | - Andracco Romina
- Hospital Santa Corona Pietra Ligure, Internal Medicine Unit, Rheumatology outpatient clinic, Unit of Diagnostic and Interventional Radiology, Pietra Ligure, Italy
| | - Mansueto Natalia
- Hospital Santa Corona Pietra Ligure, Internal Medicine Unit, Rheumatology outpatient clinic, Unit of Diagnostic and Interventional Radiology, Pietra Ligure, Italy
| | - Ferrero Giulio
- Hospital Santa Corona Pietra Ligure, Internal Medicine Unit, Rheumatology outpatient clinic, Unit of Diagnostic and Interventional Radiology, Pietra Ligure, Italy
| | - Del Medico Patrizia
- Civitanova Marche Hospital, Rheumatology outpatient clinic, Internal Medicine Unit, Civitanova Marche, Italy
| | | | | | | | | | - Sandri Gilda
- University of Modena and Reggio Emilia, Rheumatology Unit, Modena and Reggio Emilia, Italy
| | - Salvarani Carlo
- University of Modena and Reggio Emilia, Rheumatology Unit, Modena and Reggio Emilia, Italy
| | - Priora Marta
- ASL 15 Cuneo, Rheumatology Day Hospital and outpatient clinic, Mondovì, Italy
| | | | - Nucera Valeria
- ASL 13 Novara, Rheumatology Outpatient Unit, Novara, Italy
| | - Santilli Daniele
- Azienda Ospedaliero-Universitaria di Parma, Department of Medicine, Internal Medicine and Rheumatology Unit, Parma, Italy
| | - Lucchini Gianluca
- Azienda Ospedaliero-Universitaria di Parma, Department of Medicine, Internal Medicine and Rheumatology Unit, Parma, Italy
| | - Giuditta Adorni
- Azienda Ospedaliero-Universitaria di Parma, Department of Medicine, Internal Medicine and Rheumatology Unit, Parma, Italy
| | - Di Donato Eleonora
- Azienda Ospedaliero-Universitaria di Parma, Department of Medicine, Internal Medicine and Rheumatology Unit, Parma, Italy
| | - Bravi Elena
- Guglielmo da Saliceto Hospital, Department of Medicine, Internal Medicine and Rheumatology Unit, Piacenza, Italy
| | - Platè Ilaria
- Guglielmo da Saliceto Hospital, Department of Medicine, Internal Medicine and Rheumatology Unit, Piacenza, Italy
| | - Arrigoni Eugenio
- Guglielmo da Saliceto Hospital, Department of Medicine, Internal Medicine and Rheumatology Unit, Piacenza, Italy
| | - Bezzi Alessandra
- ASL 13 Rimini, Internal Medicine and Rheumatology Unit, Rimini, Italy
| | | | - Mascella Fabio
- ASL 13 Rimini, Internal Medicine and Rheumatology Unit, Rimini, Italy
| | - Bruzzese Vincenzo
- Ospedale Nuovo Regina Margherita, Internal Medicine and Rheumatology Unit, Rome, Italy
| | | | | | - Rovera Guido
- PO S Andrea di Vercelli, Unit of Rheumatology, Vercelli, Italy
| | - Vitetta Rosetta
- PO S Andrea di Vercelli, Unit of Rheumatology, Vercelli, Italy
| | - Marchetta Antonio
- IRCCS Ospedale Sacro Cuore Don Calabria, Rheumatology Unit, Negrar, Italy
| | - Volpe Alessandro
- IRCCS Ospedale Sacro Cuore Don Calabria, Rheumatology Unit, Negrar, Italy
| | - Ometto Francesca
- Azienda ULSS 6 Euganea, Rheumatology Outpatient Clinic, Padova, Italy
| | - Ariani Alarico
- Azienda Ospedaliero-Universitaria di Parma, Department of Medicine, Internal Medicine and Rheumatology Unit, Parma, Italy
| | - Fusaro Enrico
- Azienda Ospedaliero Universitaria Città della Salute e della Scienza di Torino, Rheumatology Unit, Turin, Italy
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