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A Study in Participants With Moderate to Severe Rheumatoid Arthritis

A Randomized, Double-Blind, Active-Controlled, Phase 3 Study to Evaluate the Efficacy and Safety of Baricitinib (LY3009104) in Patients With Moderately to Severely Active Rheumatoid Arthritis Who Have Had Limited or No Treatment With Disease-Modifying Antirheumatic Drugs

Status
Completed
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT01711359
Acronym
RA-BEGIN
Enrollment
588
Registered
2012-10-22
Start date
2012-11-30
Completion date
2015-08-31
Last updated
2019-09-19

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Rheumatoid Arthritis

Brief summary

The purpose of this study is to determine whether baricitinib therapy alone is noninferior to methotrexate (MTX) therapy alone in the treatment of moderate to severe active rheumatoid arthritis (RA) in those who have had limited or no treatment with MTX and are naive to other conventional or biologic disease-modifying antirheumatic drugs (DMARDs).

Interventions

DRUGBaricitinib

Administered orally

DRUGMethotrexate

Administered orally

Baricitinib placebo administered orally once daily.

MTX placebo administered orally once weekly.

DRUGFolic Acid

Administered orally every day

Sponsors

Eli Lilly and Company
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No

Inclusion criteria

* Have a diagnosis of adult-onset rheumatoid arthritis (RA) as defined by American College of Rheumatology/ European League Against Rheumatism (ACR/EULAR) 2010 Criteria for the Classification of RA * Have documented history of positive rheumatoid factor and/or cyclic citrullinated peptide (CCP) antibody test * Have moderately to severely active RA defined as the presence of at least 6/68 tender joints and at least 6/66 swollen joints * Have a C-reactive protein (CRP) or high-sensitivity C-reactive protein (hsCRP) measurement ≥1.2 times the upper limit of normal (ULN) * Have had limited or no treatment with methotrexate (MTX)

Exclusion criteria

* Have received conventional disease-modifying antirheumatic drugs (DMARDs) other than MTX (eg, gold salts, cyclosporine, leflunomide, azathioprine, hydroxychloroquine, sulfasalazine or any other immunosuppressives) * Are currently receiving corticosteroids at doses \>10 mg per day of prednisone (or equivalent) or have been receiving an unstable dosing regimen of corticosteroids within 2 weeks of study entry or within 6 weeks of planned randomization * Have started treatment with non-steroidal anti-inflammatory drugs (NSAIDs) or have been receiving an unstable dosing regimen of NSAIDs within 2 weeks of study entry or within 6 weeks of planned randomization * Have started a new physiotherapy treatment for RA in the 2 weeks prior to study entry * Have ever received any biologic DMARD * Have received interferon therapy within 4 weeks prior to study entry or are anticipated to require interferon therapy during the study * Have received any parenteral corticosteroid administered by intramuscular or intravenous (IV) injection within 2 weeks prior to study entry or within 6 weeks prior to planned randomization or are anticipated to require a parenteral injection of corticosteroids during the study * Have had 3 or more joints injected with intraarticular corticosteroids or hyaluronic acid within 2 weeks prior to study entry or within 6 weeks prior to planned randomization * Have active fibromyalgia that, in the investigator's opinion, would make it difficult to appropriately assess RA activity for the purposes of this study * Have a diagnosis of any systemic inflammatory condition other than RA, such as, but not limited to, juvenile chronic arthritis, spondyloarthropathy, Crohn's disease, ulcerative colitis, psoriatic arthritis, active vasculitis, or gout (Participants with secondary Sjogren's syndrome are not excluded.) * Have a diagnosis of Felty's syndrome * Have had any major surgery within 8 weeks of study entry or will require major surgery during the study that, in the opinion of the investigator in consultation with Lilly or its designee, would pose an unacceptable risk to the participant * Have experienced any of the following within 12 weeks of study entry: myocardial infarction, unstable ischemic heart disease, stroke, or New York Heart Association Stage IV heart failure * Have a history or presence of cardiovascular, respiratory, hepatic, gastrointestinal, endocrine, hematological, neurological, or neuropsychiatric disorders or any other serious and/or unstable illness that, in the opinion of the investigator, could constitute a risk when taking investigational product or could interfere with the interpretation of data * Are largely or wholly incapacitated permitting little or no self care, such as, being bedridden or confined to a wheelchair * Have an estimated Glomerular Filtration Rate (eGFR) based on the most recent available serum creatinine using the Modification of Diet in Renal Disease (MDRD) method of \<40 milliliter per minute per 1.73 m\^2 (mL/min/1.73 m\^2) * Have a history of chronic liver disease with the most recent available aspartate aminotransferase (AST) or alanine aminotransferase (ALT) \>1.5 times the ULN or the most recent available total bilirubin ≥1.5 times the ULN * Have a history of, lymphoproliferative disease; or have signs or symptoms suggestive of possible lymphoproliferative disease, including lymphadenopathy or splenomegaly; or have active primary or recurrent malignant disease; or have been in remission from clinically significant malignancy for \<5 years * Have been exposed to a live vaccine within 12 weeks prior to planned randomization or are expected to need/receive a live vaccine during the course of the study (with the exception of herpes zoster vaccination) * Have a current or recent clinically serious viral, bacterial, fungal, or parasitic infection * Have had symptomatic herpes zoster infection within 12 weeks prior to study entry * Have a history of disseminated/complicated herpes zoster (eg, multidermatomal involvement, ophthalmic zoster, central nervous system involvement, postherpetic neuralgia) * Are immunocompromised and, in the opinion of the investigator, are at an unacceptable risk for participating in the study * Have a history of active hepatitis B virus (HBV), hepatitis C virus (HCV), or human immunodeficiency virus (HIV) * Have screening laboratory test values, including thyroid-stimulating hormone (TSH), outside the reference range for the population or investigative site that, in the opinion of the investigator, pose an unacceptable risk for the participant's participation in the study * Have screening electrocardiogram (ECG) abnormalities that, in the opinion of the investigator or the sponsor, are clinically significant and indicate an unacceptable risk for the participant's participation in the study * Have symptomatic herpes simplex at the time of study enrollment * Have evidence of active or latent tuberculosis (TB)

Design outcomes

Primary

MeasureTime frameDescription
Percentage of Participants Achieving American College of Rheumatology 20% Improvement (ACR20)Week 24ACR20 Responder Index is a composite of clinical, laboratory, and functional measures in rheumatoid arthritis (RA). ACR20 Responder is a participant who has at least 20% improvement in both tender and swollen joint counts and in at least 3 of the following 5 criteria: Physician's Global Assessment of Disease Activity, Patient's Global Assessment of Disease Activity using visual analog scale (VAS), Health Assessment Questionnaire-Disability Index (HAQ-DI), pain due to arthritis, and high-sensitivity C-reactive protein (hsCRP). Participants with missing responses and participants who discontinued study or drug or were rescued before analysis time point were deemed non-responders.

Secondary

MeasureTime frameDescription
Change From Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI) ScoreBaseline, Week 24HAQ-DI assesses the participant's self-perception on the degree of difficulty \[0 (without any difficulty), 1 (with some difficulty), 2 (with much difficulty), and 3 (unable to do)\] when dressing and grooming, arising, eating, walking, hygiene, reaching, gripping, and performing other daily activities. Scores for each functional area are averaged to calculate the HAQ-DI score, which ranges from 0 (no disability) to 3 (worst disability). A decrease in HAQ-DI score indicates an improvement in the participant's condition.
Change From Baseline in the Disease Activity Score Based on a 28-Joint Count and High-sensitivity C-reactive Protein (DAS28-hsCRP)Baseline, Week 24Disease Activity Score (DAS) modified to include 28 joint count (DAS28) consisted of a composite score of the following variables: tender joint count (TJC28), swollen joint count (SJC28), C-reactive protein (CRP) (milligrams per liter), and Patient's Global Assessment of Disease Activity. DAS28 was calculated using the following formula: DAS28-CRP=0.56\*square root (sqrt)(TJC28)+0.28\*sqrt(SJC28)+0.36\*natural log(CRP+1)+0.014\*Patient's Global VAS+0.96. Scores ranged 1.0-9.4, where lower scores indicated less disease activity.
Change From Baseline in the Modified Total Sharp Score (mTSS)Baseline, Week 24X-rays of the hands/wrists and feet were scored for structural progression as measured using the mTSS (van der Heijde 2000). This methodology quantified the extent of bone erosions and joint space narrowing for 44 and 42 joints, with higher scores representing greater damage. The mTSS at a time point is the sum of the erosion (range from 0 to 280) and JSN (range from 0 to 168) scores, for a maximum score of 448.
Percentage of Participants Who Achieved a Simplified Disease Activity Index (SDAI) Score ≤3.3Week 24SDAI is a tool for measurement of disease activity in RA that integrates TJC28, SJC28, acute phase response using C-reactive protein (milligrams per liter), Patient's Global Assessment of Disease Activity using VAS centimeters (cm), and Physician's Global Assessment of Disease Activity using VAS (cm). The SDAI is calculated by summing the values of the 5 components. Lower scores indicated less disease activity. An index-based definition of remission occurs with an SDAI score ≤3.3.
Percentage of Participants Achieving American College of Rheumatology 50% (ACR50) ResponseWeek 12, Week 24, Week 52ACR50 Responder Index is composite of clinical, laboratory, and functional measures in RA. ACR50 Responder is a participant who has at least 50% improvement in both tender and swollen joint counts and in at least 3 of the following 5 criteria: Physician's Global Assessment of Disease Activity, Patient's Global Assessment of Disease Activity, HAQ-DI, pain due to arthritis, and hsCRP. Participants with missing responses and participants who discontinued study or drug or were rescued before analysis time point were deemed non-responders.
Percentage of Participants Achieving American College of Rheumatology 70% (ACR70) ResponseWeek 12, Week 24, Week 52ACR70 Responder Index is composite of clinical, laboratory, and functional measures in RA. ACR70 Responder is a participant who has at least 70% improvement in both tender and swollen joint counts and in at least 3 of the following 5 criteria: Physician's Global Assessment of Disease Activity, Patient's Global Assessment of Disease Activity, HAQ-DI, pain due to arthritis, and hsCRP. Participants with missing responses and participants who discontinued study or drug or were rescued before analysis timepoint were deemed non-responders.
Change From Baseline in Clinical Disease Activity Index (CDAI) ScoreBaseline, Week 24; Baseline, Week 52The CDAI is a tool for measurement of disease activity in RA that does not require a laboratory component and was scored by the investigative site. It integrates TJC28 (scored 0-28 with higher scores indicating higher disease activity), SJC28 (scored 0-28 with higher scores indicating higher disease activity), Patient's Global Assessment of Disease Activity (scored on a visual analogue scale from 0-10 cm with higher scores indicating higher disease activity), and Physician's Global Assessment of Disease Activity (scored on a visual analogue scale from 0-10 cm with higher scores indicating higher disease activity). The CDAI is calculated by summing the values of the 4 components. CDAI scores range from 0 to 76; lower scores indicated lower disease activity. A negative change from baseline indicates improvement in condition.
Change From Baseline in Disease Activity Score 28-Erythrocyte Sedimentation Rate (DAS28-ESR)Baseline, Week 24; Baseline, Week 52DAS28 consisted of a composite score of the following variables: tender joint count (TJC28), swollen joint count (SJC28), erythrocyte sedimentation rate (ESR) (millimeters per hour), and Patient's Global Assessment of Disease Activity. DAS28 was calculated using the following formula: DAS28-ESR=0.56\*square root (sqrt)(TJC28)+0.28\*sqrt(SJC28)+0.70\*natural log(ESR)+0.014\*Patient's Global VAS. Scores ranged 1.0-9.4, where lower scores indicated less disease activity.
Percentage of Participants Achieving American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) RemissionWeek 12, Week 24, Week 52The ACR/EULAR definitions of RA remission include a Boolean-based definition. The Boolean-based definition of remission occurs when all 4 of the following criteria are met at the same visit: TJC28 ≤1, SJC28 ≤1, acute phase response using C-reactive protein (milligrams per deciliter) ≤1, Patient's Global Assessment of Disease Activity using VAS (cm) ≤1.
Change From Baseline in Joint Space Narrowing and Bone Erosion ScoresBaseline, Week 24; Baseline, Week 52X-rays of the hands/wrists and feet were assessed for joint space narrowing (JSN) and bone erosions. Assessment of JSN for each hand (15 joints per hand) and foot (6 joints per foot), including subluxation, is scored from 0 to 4, with 0 indicating no (normal) JSN and 4 indicating complete loss of joint space, bony ankylosis or luxation. JSN scores ranged from 0-168. A score of 0 would indicate no change and higher scores represent a worsening of joint space narrowing. The bone erosion score is a summary of erosion severity in 32 joints of the hands and 12 joints of the feet. Each joint is scored according to the surface area involved from 0 to 5 for hand joints and 0 to 10 for the foot joints, with 0 indicating no erosion and the highest score (5 for the hand and 10 for the foot) indicating extensive loss of bone from more than one half of the articulating bone. Erosion scores ranged from 0 (no erosion) to 280 (high erosion).
Percentage of Participants Achieving American College of Rheumatology 20% Improvement (ACR20)Week 52ACR20 Responder Index is a composite of clinical, laboratory, and functional measures in rheumatoid arthritis (RA). ACR20 Responder is a participant who has at least 20% improvement in both tender and swollen joint counts and in at least 3 of the following 5 criteria: Physician's Global Assessment of Disease Activity, Patient's Global Assessment of Disease Activity using visual analog scale (VAS), Health Assessment Questionnaire-Disability Index (HAQ-DI), pain due to arthritis, and high-sensitivity C-reactive protein (hsCRP). Participants with missing responses and participants who discontinued study or drug or were rescued before analysis time point were deemed non-responders.
Change From Baseline in Worst Tiredness Numeric Rating Scale (NRS)Baseline, Week 24; Baseline Week 52Participants rated their tiredness by selecting a number from 0 to 10 that best described their worst tiredness during the last 24 hours, where 0 represents no tiredness and 10 represents as bad as you can imagine.
Change From Baseline in Worst Joint Pain Numeric Rating Scale (NRS)Baseline, Week 24; Baseline Week 52Participants rated their joint pain by selecting a number from 0 to 10 that best described their worst joint pain during the last 24 hours, where 0 represents no pain and 10 represents pain as bad as you can imagine.
Change From Baseline in Mental Component Score (MCS) and Physical Component Score (PCS) of the Medical Outcomes Study 36-Item Short Form Health Survey Version 2 Acute (SF-36v2 Acute)Baseline, Week 24; Baseline Week 52The SF-36 is a health-related survey that assesses participant's quality of life and consists of 36 questions covering 8 health domains: physical functioning, bodily pain, role limitations due to physical problems and emotional problems, general health, mental health, social functioning, vitality, and 2 component scores (MCS and PCS). MCS consisted of social functioning, vitality, mental health, and role-emotional scales. PCS consisted of physical functioning, bodily pain, role-physical, and general health scales. Each domain is scored by summing the individual items and transforming the scores into a 0 to 100 scale with higher scores indicating better health status or functioning.
Change From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) ScoresBaseline, Week 24; Baseline Week 52European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) is a standardized measure of health status of the participant. One component consists of a descriptive system of the respondent's health comprised of the following 5 participant-reported dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems, and extreme problems. The responses are used to derive the health state index scores using the United Kingdom (UK) algorithm, with scores ranging from -0.594 to 1, and the United States (US) algorithm, with scores ranging from -0.109 to 1. A higher score indicates better health state.
Change From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) Scores (Self-Perceived Health)Baseline, Week 24; Baseline Week 52A second component of the EQ-5D-5L is a self-perceived health score which is assessed using a VAS that ranges from 0 to 100 millimeter (mm), where 0 indicates the worst health you can imagine and 100 indicates the best health you can imagine.
Change From Baseline in Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) ScoresBaseline, Week 24; Baseline Week 52The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) Scale is a13-item, symptom-specific questionnaire that specifically assesses the participant's self-reported severity of fatigue and its impact upon daily activities and functioning. The FACIT-F uses a numeric rating scale of 0 (Not at all) to 4 (Very much) for each item to assess fatigue and its impact in the past 7 days. Total scores range from 0 to 52, with higher scores indicating less fatigue.
Change From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresBaseline, Week 24; Baseline Week 52The Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) questionnaire was developed to measure the effect of general health and symptom severity on work productivity and regular activities in the 7 days prior to the visit. It contains 6 items covering overall work productivity (health), overall work productivity (symptom), impairment of regular activities (health), and impairment of regular activities (symptom). Scores are calculated as impairment percentages. The WPAI-RA yields four types of scores: Absenteeism (work time missed), Presenteeism (impairment at work), Work productivity loss (overall work impairment), and Activity impairment.
Population Pharmacokinetics (PK): Peak Concentration at Steady State (Cmax,ss) of BaricitinibWeek 0: 15 and 60 minutes postdose; Week 4: 2 to 4 hours post-dose; Week 8: 4 to 6 hours post-dose; Week 12; Week 24; Week 32; Pre-dose
Population PK: Area Under the Concentration Versus Time Curve at a Dosing Interval at Steady State (AUCtau,ss) of BaricitinibWeek 0: 15 and 60 minutes postdose; Week 4: 2 to 4 hours post-dose; Week 8: 4 to 6 hours post-dose; Week 12; Week 24; Week 32; Pre-dose
Change From Baseline in Duration of Morning Joint StiffnessBaseline, Week 52Participants reported the duration of their morning joint stiffness (MJS) in hours and minutes. The participants were asked about their duration of morning joint stiffness on the day prior to the study visit to capture actual symptoms, since the participant may have had an atypical morning routine on the day of the study visit. If morning joint stiffness duration was longer than 12 hours (720 minutes), it was truncated to 720 minutes for statistical presentations and analyses. A decrease in duration of morning joint stiffness indicated an improvement in the participant's condition.

Countries

Argentina, Austria, Belgium, Brazil, Canada, Germany, Greece, India, Italy, Japan, Mexico, Portugal, Puerto Rico, Russia, South Africa, South Korea, Sweden, United Kingdom, United States

Participant flow

Pre-assignment details

Participants who did not respond (nonresponders) to study drug were eligible for rescue treatment beginning at Week 24. Nonresponders were defined as lack of improvement of at least 20% in both tender joint count and swollen joint count.

Participants by arm

ArmCount
Methotrexate
Methotrexate (MTX) administered orally once weekly with dose ranging from 10 to 20 milligram (mg) per week through Week 52. Participants also received baricitinib placebo orally once daily. Starting at Week 24, participants who were nonresponders were rescued with baricitinib 4 mg orally once daily and MTX orally once weekly.
210
Baricitinib
Baricitinib 4 mg administered orally once daily through Week 52. Participants received MTX placebo orally once weekly through Week 52. Starting at Week 24, participants who were nonresponders were rescued with baricitinib 4 mg orally once daily and MTX orally once weekly.
159
Baricitinib + MTX
Baricitinib 4 mg administered orally once daily through Week 52. Participants received MTX orally once weekly with dose ranging from 10 to 20 mg per week through Week 52. Starting at Week 24, participants who were nonresponders were rescued with baricitinib 4 mg orally once daily and MTX orally once weekly.
215
Total584

Withdrawals & dropouts

PeriodReasonFG000FG001FG002
Treatment PeriodAdverse Event81024
Treatment PeriodDeath300
Treatment PeriodEntry Criteria Not Met100
Treatment PeriodLack of Efficacy1322
Treatment PeriodLost to Follow-up111
Treatment PeriodPhysician Decision432
Treatment PeriodRandomized, Not Treated310
Treatment PeriodSponsor Decision100
Treatment PeriodWithdrawal by Subject18713

Baseline characteristics

CharacteristicMethotrexateBaricitinibBaricitinib + MTXTotal
Age, Continuous50.5 years
STANDARD_DEVIATION 13.4
50.9 years
STANDARD_DEVIATION 13
48.5 years
STANDARD_DEVIATION 13.5
49.9 years
STANDARD_DEVIATION 13.4
Duration of Rheumatoid Arthritis0.2 years0.2 years0.2 years0.2 years
High sensitivity C-reactive protein22.34 milligrams per liter (mg/L)
STANDARD_DEVIATION 21.78
23.75 milligrams per liter (mg/L)
STANDARD_DEVIATION 26.24
24.27 milligrams per liter (mg/L)
STANDARD_DEVIATION 29.42
23.44 milligrams per liter (mg/L)
STANDARD_DEVIATION 25.98
Race (NIH/OMB)
American Indian or Alaska Native
11 Participants10 Participants20 Participants41 Participants
Race (NIH/OMB)
Asian
60 Participants44 Participants61 Participants165 Participants
Race (NIH/OMB)
Black or African American
10 Participants5 Participants10 Participants25 Participants
Race (NIH/OMB)
More than one race
1 Participants2 Participants1 Participants4 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
128 Participants98 Participants123 Participants349 Participants
Region of Enrollment
Argentina
41 Participants29 Participants33 Participants103 Participants
Region of Enrollment
Austria
1 Participants1 Participants1 Participants3 Participants
Region of Enrollment
Belgium
6 Participants10 Participants11 Participants27 Participants
Region of Enrollment
Brazil
8 Participants3 Participants9 Participants20 Participants
Region of Enrollment
Canada
5 Participants5 Participants7 Participants17 Participants
Region of Enrollment
Germany
5 Participants5 Participants4 Participants14 Participants
Region of Enrollment
Greece
0 Participants0 Participants1 Participants1 Participants
Region of Enrollment
India
18 Participants12 Participants17 Participants47 Participants
Region of Enrollment
Italy
8 Participants2 Participants4 Participants14 Participants
Region of Enrollment
Japan
36 Participants29 Participants39 Participants104 Participants
Region of Enrollment
Korea, Republic of
4 Participants1 Participants2 Participants7 Participants
Region of Enrollment
Mexico
12 Participants14 Participants20 Participants46 Participants
Region of Enrollment
Portugal
1 Participants0 Participants2 Participants3 Participants
Region of Enrollment
Russian Federation
11 Participants13 Participants12 Participants36 Participants
Region of Enrollment
South Africa
7 Participants4 Participants9 Participants20 Participants
Region of Enrollment
Sweden
3 Participants0 Participants1 Participants4 Participants
Region of Enrollment
United Kingdom
7 Participants3 Participants4 Participants14 Participants
Region of Enrollment
United States
37 Participants28 Participants39 Participants104 Participants
Sex: Female, Male
Female
148 Participants121 Participants156 Participants425 Participants
Sex: Female, Male
Male
62 Participants38 Participants59 Participants159 Participants
Swollen Joint Count of 66 evaluable joints16.4 number of joints
STANDARD_DEVIATION 10.6
16.1 number of joints
STANDARD_DEVIATION 9.2
16.3 number of joints
STANDARD_DEVIATION 9.5
16.3 number of joints
STANDARD_DEVIATION 9.8
Tender Joint Count of 68 evaluable joints26.5 number of joints
STANDARD_DEVIATION 14.8
26.4 number of joints
STANDARD_DEVIATION 14.1
27.7 number of joints
STANDARD_DEVIATION 14.5
26.9 number of joints
STANDARD_DEVIATION 14.5

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
EG005
affected / at risk
EG006
affected / at risk
deaths
Total, all-cause mortality
— / —— / —— / —— / —— / —— / —— / —
other
Total, other adverse events
115 / 21081 / 159129 / 21521 / 392 / 252 / 150 / 28
serious
Total, serious adverse events
20 / 21012 / 15917 / 2151 / 390 / 250 / 150 / 28

Outcome results

Primary

Percentage of Participants Achieving American College of Rheumatology 20% Improvement (ACR20)

ACR20 Responder Index is a composite of clinical, laboratory, and functional measures in rheumatoid arthritis (RA). ACR20 Responder is a participant who has at least 20% improvement in both tender and swollen joint counts and in at least 3 of the following 5 criteria: Physician's Global Assessment of Disease Activity, Patient's Global Assessment of Disease Activity using visual analog scale (VAS), Health Assessment Questionnaire-Disability Index (HAQ-DI), pain due to arthritis, and high-sensitivity C-reactive protein (hsCRP). Participants with missing responses and participants who discontinued study or drug or were rescued before analysis time point were deemed non-responders.

Time frame: Week 24

Population: Modified Intent-to-Treat (mITT) population: all randomized participants who received at least 1 dose of study drug. Missing values due to discontinuation of study or drug, rescue, or missing data were imputed using nonresponder imputation (NRI).

ArmMeasureValue (NUMBER)
MethotrexatePercentage of Participants Achieving American College of Rheumatology 20% Improvement (ACR20)61.9 Percent of participants
BaricitinibPercentage of Participants Achieving American College of Rheumatology 20% Improvement (ACR20)76.7 Percent of participants
Baricitinib + MTXPercentage of Participants Achieving American College of Rheumatology 20% Improvement (ACR20)78.1 Percent of participants
95% CI: [5.5, 24.1]
Secondary

Change From Baseline in Clinical Disease Activity Index (CDAI) Score

The CDAI is a tool for measurement of disease activity in RA that does not require a laboratory component and was scored by the investigative site. It integrates TJC28 (scored 0-28 with higher scores indicating higher disease activity), SJC28 (scored 0-28 with higher scores indicating higher disease activity), Patient's Global Assessment of Disease Activity (scored on a visual analogue scale from 0-10 cm with higher scores indicating higher disease activity), and Physician's Global Assessment of Disease Activity (scored on a visual analogue scale from 0-10 cm with higher scores indicating higher disease activity). The CDAI is calculated by summing the values of the 4 components. CDAI scores range from 0 to 76; lower scores indicated lower disease activity. A negative change from baseline indicates improvement in condition.

Time frame: Baseline, Week 24; Baseline, Week 52

Population: mITT population: all randomized participants who received at least 1 dose of study drug with a baseline value and at least 1 post-baseline value. Missing values due to discontinuation of study or drug, rescue, or missing data were imputed using modified last observation carried forward (mLOCF).

ArmMeasureGroupValue (MEAN)Dispersion
MethotrexateChange From Baseline in Clinical Disease Activity Index (CDAI) ScoreWeek 24-22.12 units on a scaleStandard Deviation 16.12
MethotrexateChange From Baseline in Clinical Disease Activity Index (CDAI) ScoreWeek 52-21.95 units on a scaleStandard Deviation 18.07
BaricitinibChange From Baseline in Clinical Disease Activity Index (CDAI) ScoreWeek 24-28.20 units on a scaleStandard Deviation 13.96
BaricitinibChange From Baseline in Clinical Disease Activity Index (CDAI) ScoreWeek 52-28.94 units on a scaleStandard Deviation 14.58
Baricitinib + MTXChange From Baseline in Clinical Disease Activity Index (CDAI) ScoreWeek 24-29.86 units on a scaleStandard Deviation 14.05
Baricitinib + MTXChange From Baseline in Clinical Disease Activity Index (CDAI) ScoreWeek 52-30.72 units on a scaleStandard Deviation 14.87
Secondary

Change From Baseline in Disease Activity Score 28-Erythrocyte Sedimentation Rate (DAS28-ESR)

DAS28 consisted of a composite score of the following variables: tender joint count (TJC28), swollen joint count (SJC28), erythrocyte sedimentation rate (ESR) (millimeters per hour), and Patient's Global Assessment of Disease Activity. DAS28 was calculated using the following formula: DAS28-ESR=0.56\*square root (sqrt)(TJC28)+0.28\*sqrt(SJC28)+0.70\*natural log(ESR)+0.014\*Patient's Global VAS. Scores ranged 1.0-9.4, where lower scores indicated less disease activity.

Time frame: Baseline, Week 24; Baseline, Week 52

Population: mITT population: all randomized participants who received at least 1 dose of study drug, with a baseline value and at least 1 post-baseline value. Missing values due to discontinuation of study or drug, rescue, or missing data were imputed using mLOCF.

ArmMeasureGroupValue (MEAN)Dispersion
MethotrexateChange From Baseline in Disease Activity Score 28-Erythrocyte Sedimentation Rate (DAS28-ESR)Week 24-2.20 units on a scaleStandard Deviation 1.53
MethotrexateChange From Baseline in Disease Activity Score 28-Erythrocyte Sedimentation Rate (DAS28-ESR)Week 52-2.32 units on a scaleStandard Deviation 1.77
BaricitinibChange From Baseline in Disease Activity Score 28-Erythrocyte Sedimentation Rate (DAS28-ESR)Week 24-2.76 units on a scaleStandard Deviation 1.45
BaricitinibChange From Baseline in Disease Activity Score 28-Erythrocyte Sedimentation Rate (DAS28-ESR)Week 52-2.84 units on a scaleStandard Deviation 1.57
Baricitinib + MTXChange From Baseline in Disease Activity Score 28-Erythrocyte Sedimentation Rate (DAS28-ESR)Week 24-3.06 units on a scaleStandard Deviation 1.46
Baricitinib + MTXChange From Baseline in Disease Activity Score 28-Erythrocyte Sedimentation Rate (DAS28-ESR)Week 52-3.22 units on a scaleStandard Deviation 1.48
Secondary

Change From Baseline in Duration of Morning Joint Stiffness

Participants reported the duration of their morning joint stiffness (MJS) in hours and minutes. The participants were asked about their duration of morning joint stiffness on the day prior to the study visit to capture actual symptoms, since the participant may have had an atypical morning routine on the day of the study visit. If morning joint stiffness duration was longer than 12 hours (720 minutes), it was truncated to 720 minutes for statistical presentations and analyses. A decrease in duration of morning joint stiffness indicated an improvement in the participant's condition.

Time frame: Baseline, Week 52

Population: mITT population: all randomized participants who received at least 1 dose of study drug, with a baseline value and at least 1 post-baseline value. Missing values due to discontinuation of study or drug, rescue, or missing data were imputed using mLOCF.

ArmMeasureValue (MEDIAN)
MethotrexateChange From Baseline in Duration of Morning Joint Stiffness-40.0 Minutes
BaricitinibChange From Baseline in Duration of Morning Joint Stiffness-55.0 Minutes
Baricitinib + MTXChange From Baseline in Duration of Morning Joint Stiffness-60.0 Minutes
Secondary

Change From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) Scores

European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) is a standardized measure of health status of the participant. One component consists of a descriptive system of the respondent's health comprised of the following 5 participant-reported dimensions: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each dimension has 5 levels: no problems, slight problems, moderate problems, severe problems, and extreme problems. The responses are used to derive the health state index scores using the United Kingdom (UK) algorithm, with scores ranging from -0.594 to 1, and the United States (US) algorithm, with scores ranging from -0.109 to 1. A higher score indicates better health state.

Time frame: Baseline, Week 24; Baseline Week 52

Population: mITT population: all randomized participants who received at least 1 dose of study drug, with a baseline value and at least 1 post-baseline value. Missing values due to discontinuation of study or drug, rescue, or missing data were imputed using mLOCF.

ArmMeasureGroupValue (MEAN)Dispersion
MethotrexateChange From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) ScoresIndex Score (US Algorithm) Week 240.142 units on a scaleStandard Deviation 0.189
MethotrexateChange From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) ScoresIndex Score (US Algorithm) Week 520.138 units on a scaleStandard Deviation 0.203
MethotrexateChange From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) ScoresIndex Score (UK Algorithm) Week 240.205 units on a scaleStandard Deviation 0.274
MethotrexateChange From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) ScoresIndex Score (UK Algorithm) Week 520.197 units on a scaleStandard Deviation 0.294
BaricitinibChange From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) ScoresIndex Score (UK Algorithm) Week 520.271 units on a scaleStandard Deviation 0.258
BaricitinibChange From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) ScoresIndex Score (US Algorithm) Week 240.197 units on a scaleStandard Deviation 0.164
BaricitinibChange From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) ScoresIndex Score (UK Algorithm) Week 240.285 units on a scaleStandard Deviation 0.241
BaricitinibChange From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) ScoresIndex Score (US Algorithm) Week 520.186 units on a scaleStandard Deviation 0.177
Baricitinib + MTXChange From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) ScoresIndex Score (UK Algorithm) Week 520.268 units on a scaleStandard Deviation 0.266
Baricitinib + MTXChange From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) ScoresIndex Score (US Algorithm) Week 520.185 units on a scaleStandard Deviation 0.186
Baricitinib + MTXChange From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) ScoresIndex Score (UK Algorithm) Week 240.282 units on a scaleStandard Deviation 0.255
Baricitinib + MTXChange From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) ScoresIndex Score (US Algorithm) Week 240.194 units on a scaleStandard Deviation 0.18
Secondary

Change From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) Scores (Self-Perceived Health)

A second component of the EQ-5D-5L is a self-perceived health score which is assessed using a VAS that ranges from 0 to 100 millimeter (mm), where 0 indicates the worst health you can imagine and 100 indicates the best health you can imagine.

Time frame: Baseline, Week 24; Baseline Week 52

Population: mITT population: all randomized participants who received at least 1 dose of study drug, with a baseline value and at least 1 post-baseline value. Missing values due to discontinuation of study or drug, rescue, or missing data were imputed using mLOCF.

ArmMeasureGroupValue (MEAN)Dispersion
MethotrexateChange From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) Scores (Self-Perceived Health)Self-Perceived Health Week 2414.5 millimeterStandard Deviation 28.3
MethotrexateChange From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) Scores (Self-Perceived Health)Self-Perceived Health Week 5213.6 millimeterStandard Deviation 30.1
BaricitinibChange From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) Scores (Self-Perceived Health)Self-Perceived Health Week 2424.1 millimeterStandard Deviation 26
BaricitinibChange From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) Scores (Self-Perceived Health)Self-Perceived Health Week 5224.5 millimeterStandard Deviation 28.7
Baricitinib + MTXChange From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) Scores (Self-Perceived Health)Self-Perceived Health Week 2421.4 millimeterStandard Deviation 31.4
Baricitinib + MTXChange From Baseline in European Quality of Life-5 Dimensions-5 Level (EQ-5D-5L) Scores (Self-Perceived Health)Self-Perceived Health Week 5224.5 millimeterStandard Deviation 30.6
Secondary

Change From Baseline in Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) Scores

The Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) Scale is a13-item, symptom-specific questionnaire that specifically assesses the participant's self-reported severity of fatigue and its impact upon daily activities and functioning. The FACIT-F uses a numeric rating scale of 0 (Not at all) to 4 (Very much) for each item to assess fatigue and its impact in the past 7 days. Total scores range from 0 to 52, with higher scores indicating less fatigue.

Time frame: Baseline, Week 24; Baseline Week 52

Population: mITT population: all randomized participants who received at least 1 dose of study drug, with a baseline value and at least 1 post-baseline value. Missing values due to discontinuation of study or drug, rescue, or missing data were imputed using mLOCF.

ArmMeasureGroupValue (MEAN)Dispersion
MethotrexateChange From Baseline in Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) ScoresWeek 249.3 units on a scaleStandard Deviation 11.2
MethotrexateChange From Baseline in Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) ScoresWeek 529.1 units on a scaleStandard Deviation 10.9
BaricitinibChange From Baseline in Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) ScoresWeek 2413.0 units on a scaleStandard Deviation 10.8
BaricitinibChange From Baseline in Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) ScoresWeek 5211.3 units on a scaleStandard Deviation 10.8
Baricitinib + MTXChange From Baseline in Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) ScoresWeek 2412.3 units on a scaleStandard Deviation 11.5
Baricitinib + MTXChange From Baseline in Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) ScoresWeek 5212.6 units on a scaleStandard Deviation 11.8
Secondary

Change From Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI) Score

HAQ-DI assesses the participant's self-perception on the degree of difficulty \[0 (without any difficulty), 1 (with some difficulty), 2 (with much difficulty), and 3 (unable to do)\] when dressing and grooming, arising, eating, walking, hygiene, reaching, gripping, and performing other daily activities. Scores for each functional area are averaged to calculate the HAQ-DI score, which ranges from 0 (no disability) to 3 (worst disability). A decrease in HAQ-DI score indicates an improvement in the participant's condition.

Time frame: Baseline, Week 24

Population: mITT population: all randomized participants who received at least 1 dose of study drug. Missing values due to discontinuation of study or drug, rescue, or missing data were imputed using modified baseline observation carried forward (mBOCF).

ArmMeasureValue (MEAN)Dispersion
MethotrexateChange From Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI) Score-0.73 units on a scaleStandard Deviation 0.71
BaricitinibChange From Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI) Score-1.01 units on a scaleStandard Deviation 0.74
Baricitinib + MTXChange From Baseline in Health Assessment Questionnaire-Disability Index (HAQ-DI) Score-0.92 units on a scaleStandard Deviation 0.74
Secondary

Change From Baseline in Joint Space Narrowing and Bone Erosion Scores

X-rays of the hands/wrists and feet were assessed for joint space narrowing (JSN) and bone erosions. Assessment of JSN for each hand (15 joints per hand) and foot (6 joints per foot), including subluxation, is scored from 0 to 4, with 0 indicating no (normal) JSN and 4 indicating complete loss of joint space, bony ankylosis or luxation. JSN scores ranged from 0-168. A score of 0 would indicate no change and higher scores represent a worsening of joint space narrowing. The bone erosion score is a summary of erosion severity in 32 joints of the hands and 12 joints of the feet. Each joint is scored according to the surface area involved from 0 to 5 for hand joints and 0 to 10 for the foot joints, with 0 indicating no erosion and the highest score (5 for the hand and 10 for the foot) indicating extensive loss of bone from more than one half of the articulating bone. Erosion scores ranged from 0 (no erosion) to 280 (high erosion).

Time frame: Baseline, Week 24; Baseline, Week 52

Population: mITT population: all randomized participants who received at least 1 dose of study drug and had baseline and at least 1 post-baseline assessment. Missing values due to discontinuation of study, rescue, or missing data were imputed using LE.

ArmMeasureGroupValue (MEAN)Dispersion
MethotrexateChange From Baseline in Joint Space Narrowing and Bone Erosion ScoresJSN Week 240.15 units on a scaleStandard Deviation 0.94
MethotrexateChange From Baseline in Joint Space Narrowing and Bone Erosion ScoresJSN Week 520.23 units on a scaleStandard Deviation 1
MethotrexateChange From Baseline in Joint Space Narrowing and Bone Erosion ScoresBone Erosion Week 240.49 units on a scaleStandard Deviation 1.14
MethotrexateChange From Baseline in Joint Space Narrowing and Bone Erosion ScoresBone Erosion Week 520.80 units on a scaleStandard Deviation 1.8
BaricitinibChange From Baseline in Joint Space Narrowing and Bone Erosion ScoresBone Erosion Week 520.55 units on a scaleStandard Deviation 1.48
BaricitinibChange From Baseline in Joint Space Narrowing and Bone Erosion ScoresJSN Week 240.08 units on a scaleStandard Deviation 0.44
BaricitinibChange From Baseline in Joint Space Narrowing and Bone Erosion ScoresBone Erosion Week 240.35 units on a scaleStandard Deviation 0.92
BaricitinibChange From Baseline in Joint Space Narrowing and Bone Erosion ScoresJSN Week 520.26 units on a scaleStandard Deviation 1.14
Baricitinib + MTXChange From Baseline in Joint Space Narrowing and Bone Erosion ScoresBone Erosion Week 520.33 units on a scaleStandard Deviation 1.21
Baricitinib + MTXChange From Baseline in Joint Space Narrowing and Bone Erosion ScoresJSN Week 520.08 units on a scaleStandard Deviation 0.88
Baricitinib + MTXChange From Baseline in Joint Space Narrowing and Bone Erosion ScoresBone Erosion Week 240.27 units on a scaleStandard Deviation 0.95
Baricitinib + MTXChange From Baseline in Joint Space Narrowing and Bone Erosion ScoresJSN Week 240.05 units on a scaleStandard Deviation 0.44
Secondary

Change From Baseline in Mental Component Score (MCS) and Physical Component Score (PCS) of the Medical Outcomes Study 36-Item Short Form Health Survey Version 2 Acute (SF-36v2 Acute)

The SF-36 is a health-related survey that assesses participant's quality of life and consists of 36 questions covering 8 health domains: physical functioning, bodily pain, role limitations due to physical problems and emotional problems, general health, mental health, social functioning, vitality, and 2 component scores (MCS and PCS). MCS consisted of social functioning, vitality, mental health, and role-emotional scales. PCS consisted of physical functioning, bodily pain, role-physical, and general health scales. Each domain is scored by summing the individual items and transforming the scores into a 0 to 100 scale with higher scores indicating better health status or functioning.

Time frame: Baseline, Week 24; Baseline Week 52

Population: mITT population: all randomized participants who received at least 1 dose of study drug, with a baseline value and at least 1 post-baseline value. Missing values due to discontinuation of study or drug, rescue, or missing data were imputed using mLOCF.

ArmMeasureGroupValue (MEAN)Dispersion
MethotrexateChange From Baseline in Mental Component Score (MCS) and Physical Component Score (PCS) of the Medical Outcomes Study 36-Item Short Form Health Survey Version 2 Acute (SF-36v2 Acute)MCS Week 243.4 units on a scaleStandard Deviation 10.8
MethotrexateChange From Baseline in Mental Component Score (MCS) and Physical Component Score (PCS) of the Medical Outcomes Study 36-Item Short Form Health Survey Version 2 Acute (SF-36v2 Acute)MCS Week 522.4 units on a scaleStandard Deviation 10.9
MethotrexateChange From Baseline in Mental Component Score (MCS) and Physical Component Score (PCS) of the Medical Outcomes Study 36-Item Short Form Health Survey Version 2 Acute (SF-36v2 Acute)PCS Week 249.4 units on a scaleStandard Deviation 9.2
MethotrexateChange From Baseline in Mental Component Score (MCS) and Physical Component Score (PCS) of the Medical Outcomes Study 36-Item Short Form Health Survey Version 2 Acute (SF-36v2 Acute)PCS Week 529.4 units on a scaleStandard Deviation 10.1
BaricitinibChange From Baseline in Mental Component Score (MCS) and Physical Component Score (PCS) of the Medical Outcomes Study 36-Item Short Form Health Survey Version 2 Acute (SF-36v2 Acute)PCS Week 5211.6 units on a scaleStandard Deviation 9.6
BaricitinibChange From Baseline in Mental Component Score (MCS) and Physical Component Score (PCS) of the Medical Outcomes Study 36-Item Short Form Health Survey Version 2 Acute (SF-36v2 Acute)MCS Week 245.9 units on a scaleStandard Deviation 11.7
BaricitinibChange From Baseline in Mental Component Score (MCS) and Physical Component Score (PCS) of the Medical Outcomes Study 36-Item Short Form Health Survey Version 2 Acute (SF-36v2 Acute)PCS Week 2412.5 units on a scaleStandard Deviation 9.1
BaricitinibChange From Baseline in Mental Component Score (MCS) and Physical Component Score (PCS) of the Medical Outcomes Study 36-Item Short Form Health Survey Version 2 Acute (SF-36v2 Acute)MCS Week 525.8 units on a scaleStandard Deviation 11.9
Baricitinib + MTXChange From Baseline in Mental Component Score (MCS) and Physical Component Score (PCS) of the Medical Outcomes Study 36-Item Short Form Health Survey Version 2 Acute (SF-36v2 Acute)PCS Week 5213.3 units on a scaleStandard Deviation 9.8
Baricitinib + MTXChange From Baseline in Mental Component Score (MCS) and Physical Component Score (PCS) of the Medical Outcomes Study 36-Item Short Form Health Survey Version 2 Acute (SF-36v2 Acute)MCS Week 525.0 units on a scaleStandard Deviation 11.5
Baricitinib + MTXChange From Baseline in Mental Component Score (MCS) and Physical Component Score (PCS) of the Medical Outcomes Study 36-Item Short Form Health Survey Version 2 Acute (SF-36v2 Acute)PCS Week 2413.2 units on a scaleStandard Deviation 9.6
Baricitinib + MTXChange From Baseline in Mental Component Score (MCS) and Physical Component Score (PCS) of the Medical Outcomes Study 36-Item Short Form Health Survey Version 2 Acute (SF-36v2 Acute)MCS Week 244.6 units on a scaleStandard Deviation 11.6
Secondary

Change From Baseline in the Disease Activity Score Based on a 28-Joint Count and High-sensitivity C-reactive Protein (DAS28-hsCRP)

Disease Activity Score (DAS) modified to include 28 joint count (DAS28) consisted of a composite score of the following variables: tender joint count (TJC28), swollen joint count (SJC28), C-reactive protein (CRP) (milligrams per liter), and Patient's Global Assessment of Disease Activity. DAS28 was calculated using the following formula: DAS28-CRP=0.56\*square root (sqrt)(TJC28)+0.28\*sqrt(SJC28)+0.36\*natural log(CRP+1)+0.014\*Patient's Global VAS+0.96. Scores ranged 1.0-9.4, where lower scores indicated less disease activity.

Time frame: Baseline, Week 24

Population: mITT population: all randomized participants who received at least 1 dose of study drug. Missing values due to discontinuation of study or drug, rescue, or missing data were imputed using mBOCF.

ArmMeasureValue (MEAN)Dispersion
MethotrexateChange From Baseline in the Disease Activity Score Based on a 28-Joint Count and High-sensitivity C-reactive Protein (DAS28-hsCRP)-2.01 units on a scaleStandard Deviation 1.51
BaricitinibChange From Baseline in the Disease Activity Score Based on a 28-Joint Count and High-sensitivity C-reactive Protein (DAS28-hsCRP)-2.74 units on a scaleStandard Deviation 1.39
Baricitinib + MTXChange From Baseline in the Disease Activity Score Based on a 28-Joint Count and High-sensitivity C-reactive Protein (DAS28-hsCRP)-2.82 units on a scaleStandard Deviation 1.58
Secondary

Change From Baseline in the Modified Total Sharp Score (mTSS)

X-rays of the hands/wrists and feet were scored for structural progression as measured using the mTSS (van der Heijde 2000). This methodology quantified the extent of bone erosions and joint space narrowing for 44 and 42 joints, with higher scores representing greater damage. The mTSS at a time point is the sum of the erosion (range from 0 to 280) and JSN (range from 0 to 168) scores, for a maximum score of 448.

Time frame: Baseline, Week 24

Population: mITT population: all randomized participants who received at least 1 dose of study drug and had baseline and at least 1 post-baseline assessments. Missing values due to discontinuation of study, rescue, or missing data were imputed using linear extrapolation (LE).

ArmMeasureValue (MEAN)Dispersion
MethotrexateChange From Baseline in the Modified Total Sharp Score (mTSS)0.64 units on a scaleStandard Deviation 1.81
BaricitinibChange From Baseline in the Modified Total Sharp Score (mTSS)0.43 units on a scaleStandard Deviation 1.18
Baricitinib + MTXChange From Baseline in the Modified Total Sharp Score (mTSS)0.32 units on a scaleStandard Deviation 1.14
Secondary

Change From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) Scores

The Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) questionnaire was developed to measure the effect of general health and symptom severity on work productivity and regular activities in the 7 days prior to the visit. It contains 6 items covering overall work productivity (health), overall work productivity (symptom), impairment of regular activities (health), and impairment of regular activities (symptom). Scores are calculated as impairment percentages. The WPAI-RA yields four types of scores: Absenteeism (work time missed), Presenteeism (impairment at work), Work productivity loss (overall work impairment), and Activity impairment.

Time frame: Baseline, Week 24; Baseline Week 52

Population: mITT population: all randomized participants who received at least 1 dose of study drug, with a baseline value and an observed value at the time point being summarized.

ArmMeasureGroupValue (MEAN)Dispersion
MethotrexateChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresAbsenteeism Week 24 (n=76, 56, 90)-3.6 Percentage of ImpairmentStandard Deviation 35.5
MethotrexateChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresAbsenteeism Week 52 (n=52, 51, 71)-3.0 Percentage of ImpairmentStandard Deviation 29.2
MethotrexateChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresPresenteeism Week 24(n=70, 51, 86)-19 Percentage of ImpairmentStandard Deviation 25
MethotrexateChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresPresenteeism Week 52 (n=51, 47, 75)-26 Percentage of ImpairmentStandard Deviation 26
MethotrexateChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresWork Productivity Loss Week 24 (n=70, 71, 86)-17.8 Percentage of ImpairmentStandard Deviation 30.2
MethotrexateChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresWork Productivity Loss Week 52 (n=51, 47, 75)-24.1 Percentage of ImpairmentStandard Deviation 30.5
MethotrexateChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresActivity Impairment Week 24 (n=184, 145, 192)-25 Percentage of ImpairmentStandard Deviation 26
MethotrexateChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresActivity Impairment Week 52 (n=141, 131, 172)-28 Percentage of ImpairmentStandard Deviation 27
BaricitinibChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresPresenteeism Week 24(n=70, 51, 86)-26 Percentage of ImpairmentStandard Deviation 27
BaricitinibChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresActivity Impairment Week 24 (n=184, 145, 192)-36 Percentage of ImpairmentStandard Deviation 28
BaricitinibChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresPresenteeism Week 52 (n=51, 47, 75)-27 Percentage of ImpairmentStandard Deviation 24
BaricitinibChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresWork Productivity Loss Week 24 (n=70, 71, 86)-25.6 Percentage of ImpairmentStandard Deviation 29.1
BaricitinibChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresWork Productivity Loss Week 52 (n=51, 47, 75)-27.6 Percentage of ImpairmentStandard Deviation 27.3
BaricitinibChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresAbsenteeism Week 24 (n=76, 56, 90)-8.7 Percentage of ImpairmentStandard Deviation 30.4
BaricitinibChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresAbsenteeism Week 52 (n=52, 51, 71)-8.4 Percentage of ImpairmentStandard Deviation 29.7
BaricitinibChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresActivity Impairment Week 52 (n=141, 131, 172)-34 Percentage of ImpairmentStandard Deviation 27
Baricitinib + MTXChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresPresenteeism Week 24(n=70, 51, 86)-32 Percentage of ImpairmentStandard Deviation 26
Baricitinib + MTXChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresAbsenteeism Week 52 (n=52, 51, 71)-7.3 Percentage of ImpairmentStandard Deviation 21.8
Baricitinib + MTXChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresAbsenteeism Week 24 (n=76, 56, 90)-7.6 Percentage of ImpairmentStandard Deviation 26.5
Baricitinib + MTXChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresPresenteeism Week 52 (n=51, 47, 75)-33 Percentage of ImpairmentStandard Deviation 25
Baricitinib + MTXChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresActivity Impairment Week 24 (n=184, 145, 192)-31 Percentage of ImpairmentStandard Deviation 28
Baricitinib + MTXChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresWork Productivity Loss Week 52 (n=51, 47, 75)-33.8 Percentage of ImpairmentStandard Deviation 27.5
Baricitinib + MTXChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresWork Productivity Loss Week 24 (n=70, 71, 86)-30.9 Percentage of ImpairmentStandard Deviation 29.6
Baricitinib + MTXChange From Baseline in Work Productivity and Activity Impairment-Rheumatoid Arthritis (WPAI-RA) ScoresActivity Impairment Week 52 (n=141, 131, 172)-37 Percentage of ImpairmentStandard Deviation 27
Secondary

Change From Baseline in Worst Joint Pain Numeric Rating Scale (NRS)

Participants rated their joint pain by selecting a number from 0 to 10 that best described their worst joint pain during the last 24 hours, where 0 represents no pain and 10 represents pain as bad as you can imagine.

Time frame: Baseline, Week 24; Baseline Week 52

Population: mITT population: all randomized participants who received at least 1 dose of study drug, with a baseline value and at least 1 post-baseline value. Missing values due to discontinuation of study or drug, rescue, or missing data were imputed using mLOCF.

ArmMeasureGroupValue (MEAN)Dispersion
MethotrexateChange From Baseline in Worst Joint Pain Numeric Rating Scale (NRS)Week 52-3.0 units on a scaleStandard Deviation 2.8
MethotrexateChange From Baseline in Worst Joint Pain Numeric Rating Scale (NRS)Week 24-2.8 units on a scaleStandard Deviation 2.5
BaricitinibChange From Baseline in Worst Joint Pain Numeric Rating Scale (NRS)Week 24-3.9 units on a scaleStandard Deviation 2.7
BaricitinibChange From Baseline in Worst Joint Pain Numeric Rating Scale (NRS)Week 52-3.9 units on a scaleStandard Deviation 2.9
Baricitinib + MTXChange From Baseline in Worst Joint Pain Numeric Rating Scale (NRS)Week 24-3.9 units on a scaleStandard Deviation 2.6
Baricitinib + MTXChange From Baseline in Worst Joint Pain Numeric Rating Scale (NRS)Week 52-4.1 units on a scaleStandard Deviation 2.7
Secondary

Change From Baseline in Worst Tiredness Numeric Rating Scale (NRS)

Participants rated their tiredness by selecting a number from 0 to 10 that best described their worst tiredness during the last 24 hours, where 0 represents no tiredness and 10 represents as bad as you can imagine.

Time frame: Baseline, Week 24; Baseline Week 52

Population: mITT population: all randomized participants who received at least 1 dose of study drug, with a baseline value and at least 1 post-baseline value. Missing values due to discontinuation of study or drug, rescue, or missing data were imputed using mLOCF.

ArmMeasureGroupValue (MEAN)Dispersion
MethotrexateChange From Baseline in Worst Tiredness Numeric Rating Scale (NRS)Week 24-2.2 units on a scaleStandard Deviation 2.7
MethotrexateChange From Baseline in Worst Tiredness Numeric Rating Scale (NRS)Week 52-2.3 units on a scaleStandard Deviation 2.8
BaricitinibChange From Baseline in Worst Tiredness Numeric Rating Scale (NRS)Week 24-3.0 units on a scaleStandard Deviation 3.1
BaricitinibChange From Baseline in Worst Tiredness Numeric Rating Scale (NRS)Week 52-2.9 units on a scaleStandard Deviation 3.1
Baricitinib + MTXChange From Baseline in Worst Tiredness Numeric Rating Scale (NRS)Week 24-3.0 units on a scaleStandard Deviation 2.8
Baricitinib + MTXChange From Baseline in Worst Tiredness Numeric Rating Scale (NRS)Week 52-3.0 units on a scaleStandard Deviation 2.9
Secondary

Percentage of Participants Achieving American College of Rheumatology 20% Improvement (ACR20)

ACR20 Responder Index is a composite of clinical, laboratory, and functional measures in rheumatoid arthritis (RA). ACR20 Responder is a participant who has at least 20% improvement in both tender and swollen joint counts and in at least 3 of the following 5 criteria: Physician's Global Assessment of Disease Activity, Patient's Global Assessment of Disease Activity using visual analog scale (VAS), Health Assessment Questionnaire-Disability Index (HAQ-DI), pain due to arthritis, and high-sensitivity C-reactive protein (hsCRP). Participants with missing responses and participants who discontinued study or drug or were rescued before analysis time point were deemed non-responders.

Time frame: Week 52

Population: Modified Intent-to-Treat (mITT) population: all randomized participants who received at least 1 dose of study drug. Missing values due to discontinuation of study or drug, rescue, or missing data were imputed using nonresponder imputation (NRI).

ArmMeasureValue (NUMBER)
MethotrexatePercentage of Participants Achieving American College of Rheumatology 20% Improvement (ACR20)55.7 Percent of participants
BaricitinibPercentage of Participants Achieving American College of Rheumatology 20% Improvement (ACR20)73.0 Percent of participants
Baricitinib + MTXPercentage of Participants Achieving American College of Rheumatology 20% Improvement (ACR20)72.6 Percent of participants
Secondary

Percentage of Participants Achieving American College of Rheumatology 50% (ACR50) Response

ACR50 Responder Index is composite of clinical, laboratory, and functional measures in RA. ACR50 Responder is a participant who has at least 50% improvement in both tender and swollen joint counts and in at least 3 of the following 5 criteria: Physician's Global Assessment of Disease Activity, Patient's Global Assessment of Disease Activity, HAQ-DI, pain due to arthritis, and hsCRP. Participants with missing responses and participants who discontinued study or drug or were rescued before analysis time point were deemed non-responders.

Time frame: Week 12, Week 24, Week 52

Population: mITT population: all randomized participants who received at least 1 dose of study drug. Missing values due to discontinuation of study or drug, rescue, or missing data were imputed using NRI.

ArmMeasureGroupValue (NUMBER)
MethotrexatePercentage of Participants Achieving American College of Rheumatology 50% (ACR50) ResponseWeek 2443.3 Percent of participants
MethotrexatePercentage of Participants Achieving American College of Rheumatology 50% (ACR50) ResponseWeek 1232.9 Percent of participants
MethotrexatePercentage of Participants Achieving American College of Rheumatology 50% (ACR50) ResponseWeek 5237.6 Percent of participants
BaricitinibPercentage of Participants Achieving American College of Rheumatology 50% (ACR50) ResponseWeek 2459.7 Percent of participants
BaricitinibPercentage of Participants Achieving American College of Rheumatology 50% (ACR50) ResponseWeek 1254.7 Percent of participants
BaricitinibPercentage of Participants Achieving American College of Rheumatology 50% (ACR50) ResponseWeek 5257.2 Percent of participants
Baricitinib + MTXPercentage of Participants Achieving American College of Rheumatology 50% (ACR50) ResponseWeek 1260.0 Percent of participants
Baricitinib + MTXPercentage of Participants Achieving American College of Rheumatology 50% (ACR50) ResponseWeek 5261.9 Percent of participants
Baricitinib + MTXPercentage of Participants Achieving American College of Rheumatology 50% (ACR50) ResponseWeek 2463.3 Percent of participants
Secondary

Percentage of Participants Achieving American College of Rheumatology 70% (ACR70) Response

ACR70 Responder Index is composite of clinical, laboratory, and functional measures in RA. ACR70 Responder is a participant who has at least 70% improvement in both tender and swollen joint counts and in at least 3 of the following 5 criteria: Physician's Global Assessment of Disease Activity, Patient's Global Assessment of Disease Activity, HAQ-DI, pain due to arthritis, and hsCRP. Participants with missing responses and participants who discontinued study or drug or were rescued before analysis timepoint were deemed non-responders.

Time frame: Week 12, Week 24, Week 52

Population: mITT population: all randomized participants who received at least 1 dose of study drug. Missing values due to discontinuation of study or drug, rescue, or missing data were imputed using NRI.

ArmMeasureGroupValue (NUMBER)
MethotrexatePercentage of Participants Achieving American College of Rheumatology 70% (ACR70) ResponseWeek 2421.4 Percent of participants
MethotrexatePercentage of Participants Achieving American College of Rheumatology 70% (ACR70) ResponseWeek 1215.7 Percent of participants
MethotrexatePercentage of Participants Achieving American College of Rheumatology 70% (ACR70) ResponseWeek 5225.2 Percent of participants
BaricitinibPercentage of Participants Achieving American College of Rheumatology 70% (ACR70) ResponseWeek 2442.1 Percent of participants
BaricitinibPercentage of Participants Achieving American College of Rheumatology 70% (ACR70) ResponseWeek 1230.8 Percent of participants
BaricitinibPercentage of Participants Achieving American College of Rheumatology 70% (ACR70) ResponseWeek 5242.1 Percent of participants
Baricitinib + MTXPercentage of Participants Achieving American College of Rheumatology 70% (ACR70) ResponseWeek 1233.5 Percent of participants
Baricitinib + MTXPercentage of Participants Achieving American College of Rheumatology 70% (ACR70) ResponseWeek 5246.0 Percent of participants
Baricitinib + MTXPercentage of Participants Achieving American College of Rheumatology 70% (ACR70) ResponseWeek 2439.5 Percent of participants
Secondary

Percentage of Participants Achieving American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) Remission

The ACR/EULAR definitions of RA remission include a Boolean-based definition. The Boolean-based definition of remission occurs when all 4 of the following criteria are met at the same visit: TJC28 ≤1, SJC28 ≤1, acute phase response using C-reactive protein (milligrams per deciliter) ≤1, Patient's Global Assessment of Disease Activity using VAS (cm) ≤1.

Time frame: Week 12, Week 24, Week 52

Population: mITT population: all randomized participants who received at least 1 dose of study drug. Missing values due to discontinuation of study or drug, rescue, or missing data were imputed using NRI.

ArmMeasureGroupValue (NUMBER)
MethotrexatePercentage of Participants Achieving American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) RemissionWeek 248.6 percentage of participants
MethotrexatePercentage of Participants Achieving American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) RemissionWeek 125.7 percentage of participants
MethotrexatePercentage of Participants Achieving American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) RemissionWeek 5211.4 percentage of participants
BaricitinibPercentage of Participants Achieving American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) RemissionWeek 2418.9 percentage of participants
BaricitinibPercentage of Participants Achieving American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) RemissionWeek 1213.8 percentage of participants
BaricitinibPercentage of Participants Achieving American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) RemissionWeek 5217.0 percentage of participants
Baricitinib + MTXPercentage of Participants Achieving American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) RemissionWeek 1214.4 percentage of participants
Baricitinib + MTXPercentage of Participants Achieving American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) RemissionWeek 5220.9 percentage of participants
Baricitinib + MTXPercentage of Participants Achieving American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) RemissionWeek 2416.3 percentage of participants
Secondary

Percentage of Participants Who Achieved a Simplified Disease Activity Index (SDAI) Score ≤3.3

SDAI is a tool for measurement of disease activity in RA that integrates TJC28, SJC28, acute phase response using C-reactive protein (milligrams per liter), Patient's Global Assessment of Disease Activity using VAS centimeters (cm), and Physician's Global Assessment of Disease Activity using VAS (cm). The SDAI is calculated by summing the values of the 5 components. Lower scores indicated less disease activity. An index-based definition of remission occurs with an SDAI score ≤3.3.

Time frame: Week 24

Population: mITT population: all randomized participants who received at least 1 dose of study drug. Missing values due to discontinuation of study or drug, rescue, or missing data were imputed using NRI.

ArmMeasureValue (NUMBER)
MethotrexatePercentage of Participants Who Achieved a Simplified Disease Activity Index (SDAI) Score ≤3.310.5 percentage of participants
BaricitinibPercentage of Participants Who Achieved a Simplified Disease Activity Index (SDAI) Score ≤3.322.0 percentage of participants
Baricitinib + MTXPercentage of Participants Who Achieved a Simplified Disease Activity Index (SDAI) Score ≤3.322.8 percentage of participants
Secondary

Population Pharmacokinetics (PK): Peak Concentration at Steady State (Cmax,ss) of Baricitinib

Time frame: Week 0: 15 and 60 minutes postdose; Week 4: 2 to 4 hours post-dose; Week 8: 4 to 6 hours post-dose; Week 12; Week 24; Week 32; Pre-dose

Population: All randomized participants who received at least 1 dose of study drug (during study or rescue treatment) with evaluable PK data.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
MethotrexatePopulation Pharmacokinetics (PK): Peak Concentration at Steady State (Cmax,ss) of Baricitinib135 nanomole/Liter (nmol/L)Geometric Coefficient of Variation 23.1
Secondary

Population PK: Area Under the Concentration Versus Time Curve at a Dosing Interval at Steady State (AUCtau,ss) of Baricitinib

Time frame: Week 0: 15 and 60 minutes postdose; Week 4: 2 to 4 hours post-dose; Week 8: 4 to 6 hours post-dose; Week 12; Week 24; Week 32; Pre-dose

Population: All randomized participants who received at least 1 dose of study drug (during study or rescue treatment) with evaluable PK data.

ArmMeasureValue (GEOMETRIC_MEAN)Dispersion
MethotrexatePopulation PK: Area Under the Concentration Versus Time Curve at a Dosing Interval at Steady State (AUCtau,ss) of Baricitinib1280 nanomole/Liter (nmol/L)Geometric Coefficient of Variation 47.2

Source: ClinicalTrials.gov · Data processed: Mar 12, 2026