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Safety Profile of Baricitinib in Patients with Active Rheumatoid Arthritis with over 2 Years Median Time in Treatment

The Journal of Rheumatology December 2019, 46 (12) 1648-1649; DOI: https://doi.org/10.3899/jrheum.171361.C1
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    Table 4.

    Additional data.

    VariablesPlacebo-4mg (6 studies, to Week 24)2mg-4mg-extended, 4 Studies
    PlaceboBaricitinib 4 mgBaricitinib 2 mgBaricitinib 4 mgAll-bari-RA
    Temporary interruption because of AE ≥ 0.2 EAIR for 4 mg–treated patients in placebo-4 mg, n (EAIR)
    Skin and subcutaneous tissue disorders2 (0.5)6 (1.5)2 (0.4)5 (0.8)26 (0.4)
    Respiratory thoracic and mediastinal disorders2 (0.5)5 (1.2)6 (1.1)6 (1.0)49 (0.7)
    Surgical and medical procedures2 (0.5)4 (1.0)4 (0.7)8 (1.3)65 (1.0)
    • AE: adverse events; EAIR: exposure-adjusted incidence rates; bari: baricitinib; RA: rheumatoid arthritis.

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    Table 5 (Corrected).

    Changes in selected laboratory values and clinical chemistry (weeks 0–24).a

    Treatment-emergent shifts, n/NAR (%)Placebo-4 mg (6 studies, to Week 24)Placebo-2 mg-4 mg (4 studies, to Week 24)
    PlaceboBaricitinib 4 mgPlaceboBaricitinib 2 mgBaricitinib 4 mg
    LDLb, ≥ 130 mg/dl70/517 (13.5)243/577 (42.1)*35/225 (15.6)77/264 (29.2)‡89/248 (35.9)
    HDLb, ≥ 60 mg/dl85/442 (19.2)229/458 (50.0)*37/197 (18.8)90/214 (42.1)‡93/201 (46.3)
    Triglycerides, ≥ 500 mg/dl7/979 (0.7)5/943 (0.5)5/497 (1.0)5/444 (1.1)1/444 (0.2)
    Creatinineb
    > 1 ULN21/989 (2.1)29/951 (3.0)12/484 (2.5)12/444 (2.7)18/441 (4.1)
    > 1.5× ULN4/1010 (0.4)5/964 (0.5)1/495 (0.2)0/4525/450 (1.1)□
    CPKb
    > ULN89/954 (9.3)337/893 (37.7)*52/494 (10.5)103/451 (22.8)‡167/438 (38.1)□
    > 2.5× ULN14/1021 (1.4)52/950 (5.5)*10/538 (1.9)14/476 (2.9)33/470 (7.0)□
    > 5× ULN5/1028 (0.5)11/956 (1.2)5/543 (0.9)5/476 (1.1)8/474 (1.7)
    Hemoglobin
    < LLN193/747(25.8)204/696 (29.3)100/407 (24.6)91/343 (26.5)102/360 (28.3)
    < 10 g/dl63/1040 (6.1)60/968 (6.2)28/536 (5.2)33/462 (7.1)35/467 (7.5)
    < 8 g/dl2/1059 (0.2)1/988 (0.1)1/544 (0.2)2/477 (0.4)0/474 (0)
    Neutrophilsb, < 1000 cells/mm31/1029 (0.1)3/957 (0.3)1/544 (0.2)3/477 (0.6)1/474 (0.2)
    Lymphocytes, < 500 cells/mm310/1052 (1.0)8/987 (0.8)2/541 (0.4)6/476 (1.3)3/473 (0.6)
    Platelets
    < LLN28/1030 (2.7)16/967 (1.7)12/523 (2.3)6/466 (1.3)5/462 (1.1)
    > 600,000/mm314/1055 (1.3)23/983 (2.3)9/542 (1.7)7/472 (1.5)13/473 (2.7)
    Patients with any postbaseline elevation, n/N (%)a ALT
    > 1 ULN134/932 (14.4)221/902 (24.5)59/469 (12.6)66/431 (15.3)100/435 (23.0)
    ≥ 3× ULN14/1058 (1.3)15/987 (1.5)2/544 (0.4)7/474 (1.5)6/474 (1.3)
    ≥ 5× ULN4/1059 (0.4)7/988 (0.7)0/5443/477 (0.6)4/474 (0.8)
    ≥ 10× ULNc0/10592/988 (0.2)0/5441/477 (0.2)1/474 (0.2)
    • ↵* p < 0.05 for baricitinib 4 mg versus placebo.

    • ↵‡ p < 0.05 for baricitinib 2 mg versus placebo.

    • ↵□ p < 0.05 for baricitinib 2 mg versus 4 mg. P value from Cochran-Mantel-Haenszel test stratified by study.

    • ↵a Data up to rescue. Lipid samples were collected at weeks 0 (baseline), 12, and 24, and other hematology/clinical assessments were collected at weeks 0, 1, 2, 4, 8, 12, 14, 16, 20, and 24. National Cholesterol Education Program Adult Treatment Panel III guidelines (2002) were used for lipids19. Common Terminology Criteria for Adverse Events v3.0 were used for other laboratory variables20.

    • ↵b There were differences in laboratory assay methodologies and only the laboratory data collected using the same methodology were pulled, therefore the number of patients at risk can differ slightly across analytes.

    • ↵c Of the 3 cases of ALT ≥ 10× ULN, 1 patient had cholecystitis (study RA-BEGIN), 1 patient was receiving isoniazid treatment (study RA-BEGIN), and 1 patient started methotrexate within 6 months of randomization (study RA-BEAM). ALT: alanine aminotransferase; CPK: creatine phosphokinase; HDL: high-density lipoprotein; LDL: low-density lipoprotein; LLN: lower limit of normal; NAR: number at risk; ULN: upper limit of normal.

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1 Dec 2019
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Safety Profile of Baricitinib in Patients with Active Rheumatoid Arthritis with over 2 Years Median Time in Treatment
The Journal of Rheumatology Dec 2019, 46 (12) 1648-1649; DOI: 10.3899/jrheum.171361.C1

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