ASSOCIATION BETWEEN PATIENT-REPORTED PAIN AND ACHIEVING REMISSION OR LOW DISEASE ACTIVITY AT 3 MONTHS IN PATIENTS WITH RHEUMATOID ARTHRITIS FROM THE RA-BE-REAL STUDY

Background: In patients (pts) with inadequate response to methotrexate, baricitinib (BARI) treated pts with rheumatoid arthritis (RA) reported significantly greater and more rapid pain relief, than pts treated with adalimumab and placebo [1]. RA-BE-REAL is a 3-year, multinational, prospective, observational study of adult pts with RA starting BARI or any biologic or other targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs). Objectives: To assess the association of patient-reported pain and remission or low disease activity (LDA) at 3-month (M) in pts receiving BARI or other treatments, in RA-BE-REAL. Methods: The analyses report on pts with RA who were prescribed, for the first time, BARI (cohort A) or a tumor necrosis factor inhibitor (TNFi) (cohort B-TNFi) or any other mode of action treatment (cohort B-OMA) including other b/tsDMARDs. Pain was measured using visual analogue scale [VAS] (0-100 mm) at 3M. Proportion of pts with ≥30%, ≥50% and ≥70% pain improvement from baseline (BL) and pain VAS ≤10mm, ≤20mm and >20mm was also assessed. Disease activity was measured using clinical disease activity index (CDAI), remission (CDAI ≤2.8) or LDA (CDAI <10). Results: 673 pts with available data on disease activity at 3M were included in this analysis. At BL pts in cohort B-TNFi had a shorter disease duration and were more often naive to b/tsDMARDs. 84-97% of pts across the treatment cohorts had at least moderate pain (VAS >20mm) at BL (Table 1). A higher percentage of pts receiving BARI achieved pain improvement in all analysed thresholds than pts in cohort B-OMA at 3M. A higher percentage of pts receiving BARI experienced ≥50% and ≥70% pain improvement versus cohort B-TNFi and a similar percentage achieved ≥30% pain improvement at 3M. Achievement of pain improvement ≥30% was observed in 81% (BARI), 79% (cohort B-TNFi) and 71% (cohort B-OMA) of ≥50% in 67%, 62% and 57% and of ≥70% in 46%, 40% and 41%, respectively (Figure 1). At 3M, the proportion of pts with residual pain (VAS >20) for the treatment groups that achieved Remission/LDA or those that did not achieve Remission/LDA was 38% or 92% for BARI, 44% or 95% for cohort B-TNFi and 45% or 91% for cohort B-OMA, respectively. A higher mean change from baseline in Pain VAS measurements was observed in patients achieving remission/LDA under BARI (-32.6mm) than cohort B-TNFi (-27.3mm) and B-OMA (-28.0mm) at 3M. Conclusion: The analyses highlight the association between achievement of pain improvement and that of remission/LDA. Pts treated with BARI besides having longer disease duration and higher number of previous b/tsDMARDs are more likely to achieve pain control than pts receiving TNFi/OMA. Almost half the pts who achieved remission/LDA and who had BARI treatment achieved ≥70% pain relief. REFERENCES: [1] Taylor, P.C., et al. J Clin Med, 2019. 8 (6). Table 1. Patient Demographics and Disease Characteristics at Baseline Figure 1. Percentage of patients who achieved improvements in Pain VAS measurements ≥30%, ≥50% and ≥70% by treatment cohort and disease status at 3 months. BARI=baricitinib, TNFi= tumor necrosis factor inhibitor and OMA= other mode of action. Acknowledgements: This study was sponsored by Eli Lilly and Company. Medical writing services were provided by Joyce O’Grady, an employee of Eli Lilly and Company and was funded by Eli Lilly and Company. Disclosure of Interests: Peter C. Taylor reports consulting fees from: Abbvie, Aqtual, Inc., Biogen, Fresenius, Galapagos, Gilead, GlaxoSmithKline, Janssen, Lilly, Nordic Pharma, Pfizer, Sanofi, UCB, Acelyrin Inc, has participated on a Data Safety Monitoring Board/Advisory Board for Immunovant, Sanofi and Kymab, and has received grants/contracts from: Galapagos to University of Oxford., Walid Fakhouri is a minor shareholder of Eli Lilly and Company, and an employee of Eli Lilly and Company., Samuel Ogwu is a minor shareholder of Eli Lilly and Company, and an employee of Eli Lilly and Company., Ewa Haladyj is a minor shareholder of Eli Lilly and Company, and an employee of Eli Lilly and company., Bruno Fautrel reports consulting fees from: AbbVie, Amgen, Biogen, BMS, Celgene, Celltrion, Chugai, Fresenius Kabi, Gilead, Janssen, Lilly, Medac, MSD, Mylan, NORDIC Pharma, Novartis, Pfizer, Roche, Sandoz, Sanofi-Genzyme, SOBI, UCB, and has received grants/contracts from: Abbvie, Lilly, MSD, Novartis, Pfizer., Rieke Alten reports consulting fees from: Abbvie, Amgen, BMS, Celltrion, Chugai, Galapagos, Gilead, Janssen, Lilly, Mylan/Viatris, Novartis, Pfizer, Roche, USB, payment/honoraria from: Abbvie, Amgen, BMS, Celltrion, Chugai, Galapagos, Gilead, Janssen, Lilly, Mylan/Viatris, Novartis, Pfizer, Roche, USB and support for attending meetings/travel from: Abbvie, Amgen, BMS, Celltrion, Chugai, Galapagos, Gilead, Janssen, Lilly, Mylan/Viatris, Novartis, Pfizer, Roche, USB., Peter Nash reports consulting fees from: Amgen Abbvie BMS Janssen Lilly Novartis Servatus UCB, payment/honoraria from Amgen Abbvie BMS Janssen Lilly Novartis UCB and support for attending meetings/travel from: Novartis, Grappa steering committee Chair ARA ASMPOC, stocks from Amgen and GSK., Eugen Feist reports grant support from Lilly, payment/honoraria for lectures from Abbvie, BMS, Janssen, Medac, Novartis, Pfizer and Sobi, support for attending meetings/travel from Lilly and participated on advisory boards for: Abbvie, Novartis and Sanofi. DOI: 10.1136/annrheumdis-2024-eular.2785 Keywords: Biological DMARD, Pain, Patient Reported Outcome Measures, Real-world evidence, Remission Citation: , volume 83, supplement 1, year 2024, page 193Session: Clinical Abstract Sessions: Rheumatoid arthritis - A focus on pain and prognosis (Oral Abstract Presentations)

Biological DMARD, Pain, Patient Reported Outcome Measures, Real-world evidence, Remission