Evidence map›Paper›PMID 35134119›Full record

ArticleRheumatology (Oxford, England)2022

Effectiveness of baricitinib and tofacitinib compared with bDMARDs in RA: results from a cohort study using nationwide Swedish register data.

Andrei Barbulescu, Johan Askling, Katerina Chatzidionysiou, Helena Forsblad-d'Elia, Alf Kastbom, Ulf Lindström, Carl Turesson, Thomas Frisell

Open access · bronzeAbstract read
In one paragraph

Article in Rheumatology (Oxford, England), 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed
6.1field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed, 37 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 1 country.

Andrei BarbulescuClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet.ORCID 0000-0001-8978-1525
Johan AsklingClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet.
Katerina ChatzidionysiouRheumatology, Theme Inflammation and Ageing, Karolinska University Hospital.
Helena Forsblad-d'EliaDepartment of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Göteborg.
Alf KastbomDepartment of Biomedical and Clinical Sciences, Linköping University, Linköping.
Ulf LindströmDepartment of Rheumatology and Inflammation Research, Sahlgrenska Academy, University of Gothenburg, Göteborg.ORCID 0000-0002-2250-9348
Carl TuressonRheumatology, Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden.ORCID 0000-0002-3805-2290
Thomas FrisellClinical Epidemiology Division, Department of Medicine Solna, Karolinska Institutet.
Karolinska Institutet · SEKarolinska University Hospital · SEUniversity of Gothenburg · SELinköping University · SELund University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo describe the use of baricitinib and tofacitinib by Swedish RA patients and to compare their effectiveness with that of biologic DMARDs (bDMARDs).

methodsRA patients who initiated baricitinib (n = 1420), tofacitinib (n = 316), abatacept (n = 1050), IL-6 inhibitors (IL-6is; n = 849), rituximab (n = 1101) or TNF inhibitors (TNFis; n = 6036) between January 2017 and November 2019 were followed for a minimum of 1 year using data from several linked Swedish national registers. Proportions reaching a good EULAR 28-joint DAS (DAS28) response, HAQ Disability Index (HAQ-DI) improvement >0.2 units and Clinical Disease Activity Index (CDAI) remission were compared at 1 year, imputing discontinued treatments as 'non-response'. Additionally, we compared drug retention and changes in DAS28, HAQ-DI and CDAI from baseline to 3 months after treatment initiation.

resultsOn average, baricitinib, and particularly tofacitinib, were initiated as later lines of therapy and more frequently as monotherapy compared with rituximab and TNFi. Adjusted 1 year response proportions were consistently lower on TNFi compared with baricitinib, with differences of -4.3 percentage points (95% CI -8.7, 0.1) for good EULAR response, -9.9 (-14.4 to -5.4) for HAQ-DI improvement and -6.0 (-9.8 to -2.2) for CDAI remission. Comparisons with non-TNFi bDMARDs also favoured baricitinib, but not consistently. Treatment responses for tofacitinib were only marginally lower than those for baricitinib and generally similar to those of bDMARDs, with precision limited by low power. Comparisons of drug retention and changes in disease activity from baseline to 3 months supported the 1 year findings.

conclusionsBaricitinib and tofacitinib showed at least equivalent effectiveness compared with bDMARDs after exploring several different effectiveness measures.

Indexed as

Antirheumatic AgentsArthritis, RheumatoidBiological ProductsAbataceptAzetidinesCohort StudiesHumansInterleukin-6PiperidinesPurinesPyrazolesPyrimidinesPyrrolesRituximabSulfonamidesSwedenAbataceptAntirheumatic AgentsAzetidinesbaricitinibBiological ProductsInterleukin-6PiperidinesPurinesPyrazolesPyrimidinesPyrrolesRituximabSulfonamidestofacitinibTumor Necrosis Factor InhibitorsbaricitinibbiologicseffectivenessJanus kinase inhibitorsrheumatoid arthritistofacitinib

Identifiers

PMID35134119
PMCPMC9536798
OpenAlexW4210708653

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.