Baricitinib in polymyalgia rheumatica and giant cell arteritis: report of six cases

Submitted: 25 August 2024
Accepted: 13 October 2024
Published: 28 October 2024
Abstract Views: 659
PDF: 227
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The objective of this case series is to describe the efficacy and safety of baricitinib (BARI) in a group of patients with polymyalgia rheumatica (PMR) and/or giant cell arteritis (GCA). These patients were treated with BARI due to either a refractory disease course or the unavailability of tocilizumab because of the pandemic. A total of six patients (five females and one male, median age 64 years, range 50-83) were treated with BARI. Two of them had isolated PMR, two had PMR with associated large vessel (LV)-GCA, one had LV-GCA presenting as fever of unknown origin, and one had cranial-GCA. All patients reported improvement with BARI. At the time of starting BARI, patients were taking a median prednisone dose of 8.75 mg/day (range 0-25), and the four patients with PMR had a median PMR-AS of 23.3 (indicating high disease activity), which decreased to 1.58 after 6 months of treatment with BARI. Two of them could stop glucocorticoids (GC) and continued BARI monotherapy. One patient suffered from pneumonia, and BARI was therefore stopped. No other adverse events attributable to BARI were detected. Our case series supports previous reports suggesting efficacy of Janus kinase inhibitors as a GC-sparing strategy in PMR and GCA.

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Citations

Camellino D, Matteson EL, Buttgereit F, Dejaco C. Monitoring and long-term management of giant cell arteritis and polymyalgia rheumatica. Nat Rev Rheumatol 2020; 16: 481-95. DOI: https://doi.org/10.1038/s41584-020-0458-5
Dejaco C, Singh YP, Perel P, Hutchings A, Camellino D, Mackie S, et al. 2015 recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative. Ann Rheum Dis 2015; 74: 1799-807. DOI: https://doi.org/10.1136/annrheumdis-2015-207578
Hellmich B, Agueda A, Monti S, Buttgereit F, De Boysson H, Brouwer E, et al. 2018 Update of the EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis 2020; 79: 19-30. DOI: https://doi.org/10.1136/annrheumdis-2019-215672
Stone JH, Spotswood H, Unizony SH, Aringer M, Blockmans D, Brouwer E, et al. New-onset versus relapsing giant cell arteritis treated with tocilizumab: 3-year results from a randomized controlled trial and extension. Rheumatology 2022; 61: 2915-22. DOI: https://doi.org/10.1093/rheumatology/keab780
Fragoulis GE, McInnes IB, Siebert S. JAK-inhibitors. New players in the field of immune-mediated diseases, beyond rheumatoid arthritis. Rheumatology 2019; 58: i43-54. DOI: https://doi.org/10.1093/rheumatology/key276
Rathore U, Thakare DR, Patro P, Agarwal V, Sharma A, Misra DP. A systematic review of clinical and preclinical evidences for Janus kinase inhibitors in large vessel vasculitis. Clin Rheumatol 2022; 41: 33-44. DOI: https://doi.org/10.1007/s10067-021-05973-4
Loricera J, Tofade T, Prieto-Peña D, Romero-Yuste S, de Miguel E, Riveros-Frutos A, et al. Effectiveness of janus kinase inhibitors in relapsing giant cell arteritis in real-world clinical practice and review of the literature. Arthritis Res Ther 2024; 26: 116. DOI: https://doi.org/10.1186/s13075-024-03314-9
Devauchelle-Pensec V, Saraux L, Berthelot JM, De Bandt M, Cornec D, Guellec D, et al. Assessing polymyalgia rheumatica activity when C-reactive protein is unavailable or uninterpretable. Rheumatology 2018; 57: 666-70. DOI: https://doi.org/10.1093/rheumatology/kex477
Koster MJ, Crowson CS, Giblon RE, Jaquith JM, Duarte-García A, Matteson EL, et al. Baricitinib for relapsing giant cell arteritis: a prospective open-label 52-week pilot study. Ann Rheum Dis 2022; 81: 861-7. DOI: https://doi.org/10.1136/annrheumdis-2021-221961
Blockmans D, Penn SK, Setty A, Schmidt W, Rubbert-Roth A, Hauge EM, et al. LBA0001 efficacy and safety of upadacitinib in patients with giant cell arteritis (select-GCA): a double-blind, randomized controlled phase 3 trial. Ann Rheum Dis 2024; 83: 232-3. DOI: https://doi.org/10.1136/annrheumdis-2024-eular.LBA25
Ma X, Yang F, Wu J, Xu B, Jiang M, Sun Y, et al. Efficacy and safety of tofacitinib in patients with polymyalgia rheumatica (EAST PMR): an open-label randomized controlled trial. PLoS Med 2023; 20: e1004249. DOI: https://doi.org/10.1371/journal.pmed.1004249
Terrades-Garcia N, Cid MC. Pathogenesis of giant-cell arteritis: how targeted therapies are influencing our understanding of the mechanisms involved. Rheumatology 2018; 57: ii51-62. DOI: https://doi.org/10.1093/rheumatology/kex423
Camellino D, Giusti A, Girasole G, Bianchi G, Dejaco C. Pathogenesis, Diagnosis and Management of Polymyalgia Rheumatica. Drugs Aging 2019; 36: 1015-26. DOI: https://doi.org/10.1007/s40266-019-00705-5
Paroli M, Becciolini A, Lo Gullo A, Parisi S, Bravi E, Andracco R, et al. Influence of safety warnings on the prescribing attitude of JAK inhibitors for rheumatoid arthritis in Italy. J Clin Med 2024; 13: 3929. DOI: https://doi.org/10.3390/jcm13133929
Spinelli FR, Conti F, Caporali R, Iannone F, Cacciapaglia F, Steering Committee of the Italian Society of Rheumatology. Janus kinase inhibitors: between prescription authorization and reimbursability. Reumatismo 2023; 75: 1627. DOI: https://doi.org/10.4081/reumatismo.2023.1627

How to Cite

Camellino, D., Dejaco, C., Martini, F., Cosso, R., & Bianchi, G. (2024). Baricitinib in polymyalgia rheumatica and giant cell arteritis: report of six cases. Reumatismo. https://doi.org/10.4081/reumatismo.2024.1796

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