AB0270 EFFECTIVENESS OF A SWITCH FROM TOFACITINIB TO BARICITINIB IN RHEUMATOID ARTHRITIS: A RETROSPECTIVE ANALYSIS OF REAL-WORLD DATA IN SWITZERLAND

Background:Janus Kinase Inhibitors (JAKi) have recently been approved for the treatment of rheumatoid arthritis (RA) over the last years. JAKi differ in their specificity for the different JAK family members (JAK1, JAK2, JAK3 and TYK2). All three JAKis that are currently approved in Switzerland seem to have comparable efficacy on different disease stages of RA. Whether a JAKi can be effective after discontinuation of another JAKi is one of the open questions of interest according to the EULAR RA guidelines [1].Objectives:To study the effectiveness of baricitinib in patients with RA after discontinuation of tofacitinib.Methods:Longitudinal, retrospective chart review conducted between October 2019 and December 2020 of patients with RA at two Swiss centers (Kantonsspital Aarau and Inselspital Bern). Disease activity was assessed by DAS 28.Results:12 patients (1 male, 11 female) were treated with 4mg baricitinib/d after tofacitinib was discontinued. Mean age of the patients was 61 years, disease duration 140 months. Patients were previously treated with at least two conventional synthetic DMARDs and 75% with at least one biological DMARD. 58% of patients were positive for ACPA, 42% for rheumatoid factor. 50% of the patients suffered from erosive disease. Tofacitinib was stopped in 92% of the patients because of an insufficient response after a mean of 25.8 months. Moderate EULAR response was achieved in 83.3% of the patients after an average of 8 months treatment with baricitinib, and good EULAR response in 58.3% after an average of 10 months. There were no serious adverse events, neoplasms, opportunistic or serious infections during follow-up.Conclusion:The first retrospective analysis of real-world data of baricitinib following tofacitinib shows that there is a good clinical response in 70% of cases. Although limited by the number of patients this study therefore supports the notion that baricitinib after discontinuation of tofacitinib in RA patients may be an effective therapeutic option.References:[1]Smolen JS, Landewé RBM, Bijlsma JWJ, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update. Annals of the Rheumatic Diseases. 2020;79(6):685-699. doi:10.1136/annrheumdis-2019-216655, p. 695Disclosure of Interests:Simon Kellerhals: None declared, Jennifer Amsler: None declared, Hendrik Schulze-Koops: None declared, Thomas Hügle Consultant of: GSK, Abbvie, Pfizer, Jansen, Novartis, Eli Lilly., Michael J. Nissen Consultant of: Abbvie, Celgene, Eli-Lilly, Janssen, Novartis and Pfizer., Hasler paul Consultant of: Abbvie, Lilly, Diego Kyburz Consultant of: Abbvie, Gilead, Lilly, Novartis and Pfizer, outside of the submitted work, Rudiger Muller Consultant of: Abbvie, Novartis, Grant/research support from: Bebro Pharma