Abstract
OBJECTIVES: To evaluate the effects of baricitinib, a Janus kinase inhibitor, versus sarilumab, a human monoclonal antibody against the IL-6 receptor, on the disease activity of patients with RA. METHODS: At our hospital and cooperative facilities, we initiated treatment with baricitinib and sarilumab and observed patients with RA longitudinally for 52 weeks. Propensity score matching (age, sex, disease duration, MTX/glucocorticoid usage, RF/ACPA positivity and Disease Activity Score 28 with CRP level) was performed to address potential treatment selection bias, resulting in 46 patients in each group. The following data were collected: Disease Activity Score 28 with CRP, Clinical Disease Activity Index, Simplified Disease Activity Index, Boolean 2.0 and their component indices at weeks 24 and 52. A comparative analysis was conducted between the two groups. RESULTS: Compared with baricitinib, sarilumab induced a similar improvement in disease activity; however, baricitinib induced a significantly greater improvement in the Clinical Disease Activity Index at 24 weeks than sarilumab. At the component level, baricitinib significantly improved the number of swollen joints at 24 weeks, improving the Clinical Disease Activity Index; however, after 52 weeks, the difference between the two groups was no longer statistically significant. CONCLUSION: Compared with sarilumab, baricitinib improved swollen joints and the Clinical Disease Activity Index at 24 weeks; however, by 52 weeks, no significant difference was observed between the two groups, indicating that both treatments are important for long-term use.