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2&#46;5&#8211;20&#8239;mg&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">BARI was the first drug after failure of a csDMARD &#40;F1&#41; in 27 &#40;54&#37;&#41; patients&#44; and after failure of a bDMARD in 23 &#40;46&#37;&#41;&#58; the second drug &#40;D2&#41; in 4 &#40;8&#37;&#41;&#44; third &#40;D3&#41; in 6 &#40;12&#37;&#41;&#44; fourth &#40;D4&#41; in 8 &#40;16&#37;&#41; and fifth &#40;D5&#41; in 5 &#40;10&#37;&#41; patients&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">For the analysis&#44; during time under treatment with BARI&#44; 10 patients were discarded&#58; 8 because they came from clinical trials and 2 because they had been under treatment for less than a month&#44; leaving 20 patients in the D1 group and 20 patients in the D2-D5 group&#46; The overall average time on BARI was 9&#46;6&#8239;&#177;&#8239;3&#46;2 months&#44; and D1&#44; D2&#44; D3&#44; D4&#44; D5&#44; at 7&#46;5&#44; 7&#44; 7&#46;4&#44; 7&#46;7 and 11 months&#44; respectively&#46; The average time on BARI was 5&#46;4 months&#46; It was discontinued in 10&#47;40 &#40;25&#37;&#41; patients&#58; in 5 &#40;12&#46;5&#37;&#41; patients due to loss of effectiveness&#44; in 4 &#40;10&#37;&#41; due to complications and in one &#40;2&#46;5&#37;&#41; patient due to transfer home&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">When comparing patients treated with BARI as D1 versus group D2-D5&#44; significant differences were detected in the mean duration of RA &#40;7&#46;1&#8239;&#177;&#8239;6&#46;8 vs&#46; 14&#46;3&#8239;&#177;&#8239;8&#46;5&#44; <span class="elsevierStyleItalic">P</span>&#8239;&#61;&#8239;&#46;003&#41;&#46; Of the D2-D5 patients&#44; prior to starting on BARI&#44; 9 &#40;45&#37;&#41; D2 patients had failed to achieve one therapeutic target &#40;TT&#41;&#44; 8 &#40;40&#37;&#41; D3 patients had failed to achieve 2&#8239;TT&#44; and 3 &#40;15&#37;&#41; D4-D5 patients had failed to achieve 3&#8239;TT&#46; When comparing the results of DAS-ESR and CDAI from the baseline visit and the last visit&#44; significant differences were obtained in all groups &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">BARI treatment was discontinued in 4 &#40;20&#37;&#41; patients&#58; 2 due to herpes zoster &#40;one 58-year-old patient&#44; on treatment with 2&#46;5&#8239;mg of prednisone daily&#59; one 71-year-old patient without corticoid treatment&#59; both on methotrexate treatment at a dose of 15&#8239;mg weekly&#41;&#44; one patient due to anaemia with haemoglobin less than 8&#8239;g&#47;dL and the remaining patient due to increased transaminases&#44; not controlled by reducing the BARI dose to 2&#8239;mg&#46; During the time of the study&#44; none of the patients presented a thrombotic event&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">In this real-life study BARI was effective and safe&#46; It can achieve clinical remission or low disease activity even in patients who have previously failed with various bDMARDs or several therapeutic targets&#46; BARI losses of 20&#37; in the first year of treatment usually occur in the first six months of treatment&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interests</span><p id="par0055" class="elsevierStylePara elsevierViewall">J Rosas has participated in consultancies with Janssen&#44; Lilly and has received honoraria for talks from&#58; Abbvie&#44; Celgene&#44; Lilly&#44; MSD&#44; Novartis&#44; Pfizer&#46; JM Senabre-Gallego has received honoraria for talks from&#58; Janssen&#44; Novartis&#44; Pfizer&#46; JA Bernal has received honoraria for talks from&#58; Gr&#252;nenthal&#44; Pfizer&#46; G Santos-Soler&#44; has received honoraria for talks from&#58; Gr&#252;nenthal&#44; Pfizer&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">A Pons-Bas has no conflict of interests to declare&#46;</p></span></span>"
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          "identificador" => "sec0005"
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        1 => array:2 [
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          "titulo" => "References"
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        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Rosas J&#44; Senabre-Gallego JM&#44; Santos-Soler G&#44; Antonio Bernal J&#44; Pons Bas A&#44; Grupo Aire-Mb&#46; Eficacia y seguridad de baricitinib en pacientes con artritis reumatoide y respuesta inadecuada a FAME convencionales sint&#233;ticos o biol&#243;gicos&#58; datos de un registro local&#46; Reumatol Clin&#46; 2022&#59;18&#58;188&#8211;189&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#46;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&#46;5&nbsp;\t\t\t\t\t\t\n
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Patients treated with BARI as D1 or D2-D5&#58; DAS28-ESR and mean CDAI baseline and at last visit&#46; Ten patients were excluded&#58; 8because they came from clinical trials and two due to treatment with BARI&#8239;&#60;&#8239;1 month&#46;</p>"
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                            2 => "S&#46; Norton"
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Letter to the Editor
Efficacy and Safety of Baricitinib in Patients with Rheumatoid Arthritis and Inadequate Response to Conventional Synthetic DMARDs and/or Biological DMARDs: Data from a Local Registry
Eficacia y seguridad de baricitinib en pacientes con artritis reumatoide y respuesta inadecuada a FAME convencionales sintéticos o biológicos: datos de un registro local
José Rosasa,b,c,
Corresponding author
j.rosas.gs@gmail.com

Corresponding author.
, José Miguel Senabre-Gallegoa,b,c, Gregorio Santos-Solera,b,c, José Antonio Bernala,b,c, Ana Pons Basa,b,c, Grupo Aire-Mb
a Sección de Reumatología, Hospital Marina Baixa, Villajoyosa, Alicante, Spain
b Sección de Enfermedades Infecciosas, Hospital General Universitario de Elche, Alicante, Spain
c CIO-Universidad Miguel Hernández, Elche, Alicante, Spain
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        "titulo" => "Eficacia y seguridad de baricitinib en pacientes con artritis reumatoide y respuesta inadecuada a FAME convencionales sint&#233;ticos o biol&#243;gicos&#58; datos de un registro local"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Intracellular JAK inhibitors &#40;JAKi&#41; are a new group of drugs&#44; effective orally&#44; for the treatment of rheumatoid arthritis &#40;RA&#41;&#46; They work at the intracellular level by inhibiting several group I and II cytokines&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a> Although&#44; in general&#44; the increase in infections is similar to that of other biological drugs&#44; there appears to be a higher incidence of herpes zoster infection&#44; in particular related to age and steroid treatment&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0010" class="elsevierStylePara elsevierViewall">Baricitinib &#40;BARI&#41; is a selective JAK1-JAK2 inhibitor that&#44; when administered as a single daily dose&#44; has been shown to be effective and safe in clinical trials in patients with RA who have not responded to conventional synthetic disease modifying drugs &#40;csDMARDs&#41; or biological drugs &#40;bDMARDs&#41;&#46;<a class="elsevierStyleCrossRefs" href="#bib0015"><span class="elsevierStyleSup">3&#8211;7</span></a> However&#44; there is little information in patients from clinical practice&#46;<a class="elsevierStyleCrossRefs" href="#bib0040"><span class="elsevierStyleSup">8&#8211;11</span></a></p><p id="par0015" class="elsevierStylePara elsevierViewall">The aim of this study&#44; conducted in a real-life situation&#44; was to determine the response to BARI in patients with inadequate response to csDMARDs or bDMARDs&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">From October 2017 to June 2019 we collected patient characteristics &#40;age&#44; gender&#44; comorbidity&#44; BMI&#41;&#44; characteristics of RA and of treatment when starting BARI and at the last recorded visit &#40;disease duration&#44; RF and ACPA&#44; DAS28-ESR and CDAI&#44; previous or concomitant treatment with FAMEcs or FAMEb&#44; time on BARI&#44; reason for discontinuation of treatment&#44; severe adverse effects&#41;&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Of 230 RA patients in our centre who received a bDMARD or JAKi&#44; 50 &#40;22&#37;&#41; were treated with BARI&#46; Eighty-four percent were female&#44; with a mean age of 59&#8239;&#177;&#8239;10&#46;5 years&#44; the mean BMI was 28&#46;3&#8239;&#177;&#8239;7 and mean duration of RA was 10&#46;5&#8239;&#177;&#8239;8&#46;5 years &#40;range&#58; 1&#8211;39 years&#41;&#46; The RF and ACPA were positive at 80&#37; and 82&#37; respectively&#46; Forty-seven &#40;94&#37;&#41; patients received a concomitant csDMARD&#58; methotrexate&#58; 28 &#40;56&#37;&#41;&#44; leflunomide&#58; 15 &#40;30&#37;&#41;&#44; hydroxychloroquine&#58; 3 &#40;6&#37;&#41;&#44; and salazopyrin&#58; one &#40;2&#37;&#41;&#46; At the start of treatment with BARI 23 &#40;57&#37;&#41; patients were treated with prednisone daily &#40;mean&#58; 7&#46;2&#8239;&#177;&#8239;4&#46;7&#8239;mg&#59; median&#58; 5&#8239;mg&#59; range&#58; 2&#46;5&#8211;20&#8239;mg&#41;&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">BARI was the first drug after failure of a csDMARD &#40;F1&#41; in 27 &#40;54&#37;&#41; patients&#44; and after failure of a bDMARD in 23 &#40;46&#37;&#41;&#58; the second drug &#40;D2&#41; in 4 &#40;8&#37;&#41;&#44; third &#40;D3&#41; in 6 &#40;12&#37;&#41;&#44; fourth &#40;D4&#41; in 8 &#40;16&#37;&#41; and fifth &#40;D5&#41; in 5 &#40;10&#37;&#41; patients&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">For the analysis&#44; during time under treatment with BARI&#44; 10 patients were discarded&#58; 8 because they came from clinical trials and 2 because they had been under treatment for less than a month&#44; leaving 20 patients in the D1 group and 20 patients in the D2-D5 group&#46; The overall average time on BARI was 9&#46;6&#8239;&#177;&#8239;3&#46;2 months&#44; and D1&#44; D2&#44; D3&#44; D4&#44; D5&#44; at 7&#46;5&#44; 7&#44; 7&#46;4&#44; 7&#46;7 and 11 months&#44; respectively&#46; The average time on BARI was 5&#46;4 months&#46; It was discontinued in 10&#47;40 &#40;25&#37;&#41; patients&#58; in 5 &#40;12&#46;5&#37;&#41; patients due to loss of effectiveness&#44; in 4 &#40;10&#37;&#41; due to complications and in one &#40;2&#46;5&#37;&#41; patient due to transfer home&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">When comparing patients treated with BARI as D1 versus group D2-D5&#44; significant differences were detected in the mean duration of RA &#40;7&#46;1&#8239;&#177;&#8239;6&#46;8 vs&#46; 14&#46;3&#8239;&#177;&#8239;8&#46;5&#44; <span class="elsevierStyleItalic">P</span>&#8239;&#61;&#8239;&#46;003&#41;&#46; Of the D2-D5 patients&#44; prior to starting on BARI&#44; 9 &#40;45&#37;&#41; D2 patients had failed to achieve one therapeutic target &#40;TT&#41;&#44; 8 &#40;40&#37;&#41; D3 patients had failed to achieve 2&#8239;TT&#44; and 3 &#40;15&#37;&#41; D4-D5 patients had failed to achieve 3&#8239;TT&#46; When comparing the results of DAS-ESR and CDAI from the baseline visit and the last visit&#44; significant differences were obtained in all groups &#40;<a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0045" class="elsevierStylePara elsevierViewall">BARI treatment was discontinued in 4 &#40;20&#37;&#41; patients&#58; 2 due to herpes zoster &#40;one 58-year-old patient&#44; on treatment with 2&#46;5&#8239;mg of prednisone daily&#59; one 71-year-old patient without corticoid treatment&#59; both on methotrexate treatment at a dose of 15&#8239;mg weekly&#41;&#44; one patient due to anaemia with haemoglobin less than 8&#8239;g&#47;dL and the remaining patient due to increased transaminases&#44; not controlled by reducing the BARI dose to 2&#8239;mg&#46; During the time of the study&#44; none of the patients presented a thrombotic event&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">In this real-life study BARI was effective and safe&#46; It can achieve clinical remission or low disease activity even in patients who have previously failed with various bDMARDs or several therapeutic targets&#46; BARI losses of 20&#37; in the first year of treatment usually occur in the first six months of treatment&#46;</p><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Conflict of interests</span><p id="par0055" class="elsevierStylePara elsevierViewall">J Rosas has participated in consultancies with Janssen&#44; Lilly and has received honoraria for talks from&#58; Abbvie&#44; Celgene&#44; Lilly&#44; MSD&#44; Novartis&#44; Pfizer&#46; JM Senabre-Gallego has received honoraria for talks from&#58; Janssen&#44; Novartis&#44; Pfizer&#46; JA Bernal has received honoraria for talks from&#58; Gr&#252;nenthal&#44; Pfizer&#46; G Santos-Soler&#44; has received honoraria for talks from&#58; Gr&#252;nenthal&#44; Pfizer&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">A Pons-Bas has no conflict of interests to declare&#46;</p></span></span>"
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          "titulo" => "References"
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        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Rosas J&#44; Senabre-Gallego JM&#44; Santos-Soler G&#44; Antonio Bernal J&#44; Pons Bas A&#44; Grupo Aire-Mb&#46; Eficacia y seguridad de baricitinib en pacientes con artritis reumatoide y respuesta inadecuada a FAME convencionales sint&#233;ticos o biol&#243;gicos&#58; datos de un registro local&#46; Reumatol Clin&#46; 2022&#59;18&#58;188&#8211;189&#46;</p>"
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#91;0&#44;<a class="elsevierStyleCrossRefs" href="#bib0010">2&#8211;3&#93;</a>DAS28-ESR</th><th class="td" title="\n
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          "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Patients treated with BARI as D1 or D2-D5&#58; DAS28-ESR and mean CDAI baseline and at last visit&#46; Ten patients were excluded&#58; 8because they came from clinical trials and two due to treatment with BARI&#8239;&#60;&#8239;1 month&#46;</p>"
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                      "titulo" => "A systematic review and meta-analysis of infection risk with small molecule JAK inhibitors in rheumatoid arthritis"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "K&#46; Bechman"
                            1 => "S&#46; Subesinghe"
                            2 => "S&#46; Norton"
                            3 => "F&#46; Atzeni"
                            4 => "M&#46; Galli"
                            5 => "A&#46;P&#46; Cope"
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                  ]
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                      "Revista" => array:5 [
                        "tituloSerie" => "Rheumatology&#46;"
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                        "paginaInicial" => "1755"
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                      "titulo" => "Herpes Zoster in Tofacitinib&#58; risk is further increased with glucocorticoids but not methotrexate"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46;R&#46; Curtis"
                            1 => "F&#46; Xie"
                            2 => "S&#46; Yang"
                            3 => "S&#46; Bernatsky"
                            4 => "L&#46; Chen"
                            5 => "H&#46; Yun"
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                    0 => array:2 [
                      "doi" => "10.1002/acr.23769"
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                        "tituloSerie" => "Arthritis Care Res &#40;Hoboken&#41;&#46;"
                        "fecha" => "2019"
                        "volumen" => "71"
                        "paginaInicial" => "1249"
                        "paginaFinal" => "1254"
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                            "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30295428"
                            "web" => "Medline"
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Article information
ISSN: 21735743
Original language: English
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