EXPERIENCE IN THE CURRENT PRACTICE WITH BARICITINIB IN PATIENTS WITH RHEUMATOID ARTHRITIS AND INTERSTICIAL LUNG DISEASE OF THE DONOSTIA UNIVERSITY HOSPITAL

BackgroundBaricitinib (BARI) is a selective and reversible oral Janus kinase (JAK) inhibitor for the treatment of moderate to severe active rheumatoid arthritis (RA) in adult patients with inadequate response or intolerance to one or more antirheumatic drugs disease modifiers (DMARDs). Interstitial lung disease (ILD) is a common extra-joint manifestation of RA. Symptomatic ILD occurs in 5-17% of patients with RA and influences the natural course of the disease and substantially affects morbidity and mortality, which is why we wanted to review our patients with RA and ILD who are under treatment with BARI.ObjectivesTo assess the safety and persistence of BARI, as well as the evolution of lung function in patients with RA and ILD who are undergoing treatment with BARI, in the Rheumatology Service of the Donostia University Hospital.MethodsA retrospective search was carried out of all patients undergoing BARI treatment until June 2020. The electronic medical records were reviewed. The variables collected were: sex, age, date of diagnosis of RA, history of smoking, presence of erosions, positivity for rheumatoid factor (RF), citrullinated cyclic antipeptide (anti-CCP) and previous treatments. Regarding BARI, the dose, the time since the start of treatment, related adverse effects, reason for suspension and other relevant data were collected. The quantitative variables are shown with the median and interquartile range, the qualitative variables are shown with the absolute value and its percentage.Results17 patients with RA and ILD treated with BARI were found. Table 1 shows the clinical characteristics, Table 2 shows the treatments and Table 3 shows the respiratory function tests (RFT). All patients were positive for RF and anti-CCP, the presence of erosions was observed in 10 (59%), a history of smoking in 8 (47%), the most frequent type of ILD was Usual Interstitial Pneumopathy (UIP) 7 (41%), at the diagnosis of ILD Abatacept was the most used drug 14 (82). Before the start of BARI, the median FVC 90% (80.5-111), DLCO 69% (57-83.5) and the last control after the use of BARI the median FVC 94% (87-107), DLCO 63% (51-87), the median time of exposure to BARI was 34 months. To date, 10 (59%) patients continue with BARI and the most frequent cause of suspension was failure 2º.ConclusionA good persistence of BARI was observed (59%), it also proved to be a safe drug and kept lung function stable in these patients, so BARI can be a therapeutic option in these cases, although more studies are needed to better elucidate these findings.Figure 1.Disclosure of InterestsNone declared