Baricitinib for relapsing giant cell arteritis: a prospective open-label 52-week pilot study.
Ann Rheum Dis
; 81(6): 861-867, 2022 06.
Article
em En
| MEDLINE
| ID: mdl-35190385
ABSTRACT
BACKGROUND/PURPOSE:
Preclinical vascular inflammation models have demonstrated effective suppression of arterial wall lesional T cells through inhibition of Janus kinase 3 and JAK1. However, JAK inhibition in patients with giant cell arteritis (GCA) has not been prospectively investigated.METHODS:
We performed a prospective, open-label, pilot study of baricitinib (4 mg/day) with a tiered glucocorticoid (GC) entry and accelerated taper in patients with relapsing GCA.RESULTS:
15 patients were enrolled (11, 73% female) with a mean age at entry of 72.4 (SD 7.2) years, median duration of GCA of 9 (IQR 7-21) months and median of 1 (1-2) prior relapse. Four (27%) patients entered the study on prednisone 30 mg/day, 6 (40%) at 20 mg/day and 5 (33%) at 10 mg/day. Fourteen patients completed 52 weeks of baricitinib. At week 52, 14/15 (93%) patients had ≥1 adverse event (AE) with the most frequent events, including infection not requiring antibiotics (n=8), infection requiring antibiotics (n=5), nausea (n=6), leg swelling (n=2), fatigue (n=2) and diarrhoea (n=1). One subject required baricitinib discontinuation due to AE. One serious adverse event was recorded. Only 1 of 14 (7%) patients relapsed during the study. The remaining 13 patients achieved steroid discontinuation and remained in disease remission during the 52-week study duration.CONCLUSION:
In this proof-of-concept study, baricitinib at 4 mg/day was well tolerated and discontinuation of GC was allowed in most patients with relapsing GCA. Larger randomised clinical trials are needed to determine the utility of JAK inhibition in GCA. TRIAL REGISTRATION NUMBER NCT03026504.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Arterite de Células Gigantes
Tipo de estudo:
Clinical_trials
/
Observational_studies
Limite:
Female
/
Humans
/
Male
Idioma:
En
Revista:
Ann Rheum Dis
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Estados Unidos