LAUSR

Oral targeted synthetic disease modifying anti-rheumatic drugs (DMARDs) including baricitinib and tofacitinib (JAKi), are the latest addition to the therapeutic options for rheumatoid arthritis (RA).To assess and compare the efficacy and safety of Baricitinib and Tofacitinib in RA patients in real life.An observational longitudinal retrospective study was performed including RA patients who fulfilled the ACR/EULAR 2010 criteria and initiated treatment with Baricitinib or Tofacitinib from September 2017 to January 2020. Demographic, clinical and laboratory parameters and adverse events were collected. Infection was considered severe if it implied hospitalization. Statistical analysis was performed with R software (3.6.1) which consist in Bayesian lineal regression models including monotonic effect and Kaplan-Meier survival curves.98 patients were included. Basal characteristics are exposed in table 1.Table 1.Basal characteristicsBaricitinibn=32Tofacitinibn= 66Female sex96,88%84,85%Age53,2 (13,1)55,4 (13,4)Disease evolution (years)12,6 (9,1)14,4 (8,6)Monotherapy14 (21,21%)20 (30,3%)DMARD Metotrexate13 (40,63%)24 (36,36%) Leflunomide4 (12,5%)10 (15,15%) Hydroxychloroquine1 (3,7%)2 (3,03%)Glucocorticoids22 (68,75%)48 (72,73%)First indication6 (18,75%)22 (33,33%)After bDMARD failure24 (75%)44 (66,67%)In both groups, a significative reduction of disease activity scores was noted (graphics 1 and 2).Any difference between both treatments was detected in terms of efficacy even in first line, after bDMARD failure, in monotherapy nor combined therapy. Safety data are exposed in table 2 and neither was detected any statistical difference. In 2 of the cases of herpes zoster infection developed postherpetc neuralgia. Definitive discontinuation was registered in 23 cases (23,45%) accounting 6 (6,12%) for intolerance symptoms such as dizziness, nausea or headache (4 with Tofacitinib and 2 in Baricitinib group).Table 2.Safety dataBaricitinib n=32Tofacitinib n=66Temporary interruption24 (75%)50 (75,75%)Adverse reaction8 (25 %)17 (25.75%)Infections22 (68,75%)46 (69,69%)Serious infections3 (9,37%)5 (7,57%)Herpes Zoster2 (6,25%)2 (3,03%)Permanent discontinuation9 (28,13%)14 (28,2%)Intolerance2 (6,25)8 (12,12%)Primary failure1 (3,13%)2 (3,03%)Secondary failure5 (15,63%)3 (4,54%)Infections1 (3,13)1 (1,51%)Drug survival23 (71,87%)52 (78,78%)Survival analysis did not showed any difference between groups.Baricitinib and Tofacitinib are both comparable in terms of efficacy and safety in real world conditions.Graphic 1.Evolution of DAS28Graphic 2.Evolution of HAQNone declared