PO:07:102 | Predicting success with baricitinib in rheumatoid arthritis: efficacy across ages and serological profiles

Daniele Lini¹, Matteo Colina², Romina Andracco³, Francesca Ometto⁴, Viviana Ravagnani⁵, Alberto Lo Gullo⁶, Simone Parisi⁷, Antonella Farina⁸, Patrizia Del Medico⁹, Marino Paroli¹⁰, Olga Addimanda¹, Alessandra Bezzi¹¹, Federica Lumetti¹², Aldo Biagio Molica Colella¹³, Davide Murgia¹⁴, Maddalena Larosa¹⁵, Aurora Ianniello¹⁶, Elena Bravi¹⁷, Marta Priora¹⁸, Palma Scolieri¹⁹, Alessandro Volpe²⁰. | ¹Azienda Unità Sanitaria Locale di Bologna -- Policlinico S.Orsola- Azienda Ospedaliera Universitaria-IRCCS di Bologna, Bologna; ²Rheumatology Service. Department of Medicine and Oncology, Ospedale Santa Maria della Scaletta, Imola; ³Imperia Hospital, Internal Medicine Unit, Rheumatology outpatient clinic, Imperia; ⁴Azienda ULSS 6 Euganea, Rheumatology Outpatient Clinic, Padova; ⁵Santa Chiara Hospital APSS Trento, Rheumatology Unit, Trento; ⁶ARNAS Garibaldi di Catania, Rheumatology Unit, Catania; ⁷Azienda Ospedaliera Universitaria Città della Salute e della Scienza di Torino, Rheumatology Department, Torino; ⁸Ospedale A. Murri di Fermo, Internal Medicine Unit, Rheumatology outpatient clinic, Fermo; ⁹Civitanova Marche Hospital, Rheumatology outpatient clinic - Internal Medicine Unit, Civitanova Marche; ¹⁰Sapienza University of Rome, Polo Pontino, Department of Clinical, Anesthesiological and Cardiovascular Sciences, Latina; ¹¹ASL Romagna Rimini, Internal Medicine and Rheumatology Unit, Rimini; ¹²Azienda USL of Modena and University Hospital Policlinico di Modena, Rheumatology Unit, Modena; ¹³Rheumatology Unit, Azienda Ospedaliera Papardo, Messina; ¹⁴ASL VC Ospedale S. Andrea, Unit of Rheumatology, Vercelli; ¹⁵Azienda Sanitaria Locale 3 Genova, Division of Rheumatology - Medical Specialties Department, Genova; ¹⁶ASL Novara, Rheumatology Outpatient Unit, Novara; ¹⁷Ospedale G. Da Saliceto, Rheumatology Unit, Piacenza; ¹⁸ASL CN1, Rheumatology Day Hospital and outpatient clinic, Mondovì (CN); ¹⁹Nuovo Regina Margherita Hospital, Department of Medical Specialties, Roma; ²⁰IRCCS Sacro Cuore Don Calabria Hospital, Unit of Rheumatology, Negrar, Italy.

Background. Evaluate the real-world effectiveness of baricitinib in 423 rheumatoid arthritis (RA) patients, compare outcomes in <65 years (n=264) versus 65 years and older (n=159) patients, and identify predictors of DAS28-ESR remission/LDA at 6 and 12 months.

Methods. Retrospective multicenter cohort; recorded baseline age, sex, disease duration, and comorbidities. DAS28-ESR was measured at baseline, 6 and 12 months; remission was defined as DAS28-ESR <2.6 and LDA as <3.3. Response predictors were assessed by multivariate logistic regression, reporting OR with 95% CI and p values.

Results. Median age was 59 years (IQR 51–67); 79% female; median disease duration 76 months (IQR 31–157). Patients of 65 years and older experienced longer disease duration (94 vs 65 months; p<0.01) and higher rates of diabetes (16% vs 5%; p<0.01), dyslipidemia (47% vs 19%; p<0.01) and hypertension (62% vs 33%; p<0.01). Median DAS28-ESR fell from 5.42 (IQR 4.84–6.06) at baseline to 3.71 (IQR 2.83–4.59) at 6 months and 3.29 (IQR 2.42–4.19) at 12 months (both p<0.01). Remission/LDA was achieved by 246/422 (58.3%) at 6 months and 259/423 (61.2%) at 12 months. Age of 65 and older was not associated with response at 6 months (OR 0.71; 95% CI 0.44–1.14; p=0.16) or 12 months (OR 0.83; 95% CI 0.55–1.24; p=0.37). ACPA-positivity independently predicted remission/LDA at 6 months (OR 2.32; 95% CI 1.43–3.77; p<0.01) and 12 months (OR 1.71; 95% CI 1.12–2.59; p<0.01).

Conclusion. Baricitinib significantly reduced RA disease activity over 12 months regardless of age or comorbidities, with ACPA-positivity as a strong independent predictor of clinical response.