関節リウマチ治療におけるbaricitinibの有効性: 実臨床における線維化およびバイオマーカーに対する修飾効果
Alessandro M,
Perillo F,
Refini R,
Bergantini L,
Bellisai F,
Selvi E,
Cameli P,
Manganelli S,
Conticini E,
Cantarini L,
Sestini P,
Frediani B,
Bargagli E
Int Immunopharmacol. 2020 Sep;86:106748.
BARI demonstrated to be a safe immune modulator that reduces the concentrations biomarkers of lung fibrosis and inflammation in RA patients, including a subgroup with interstitial lung involvement. Professor Alessandro and colleagues analysed the effects of baricitinib in a population of RA and RA-ILD patients in a real-life setting, describing any changes in lung function parameters, serum inflammatory biomarkers and fibrotic biomarkers after 6 months of treatment. Fifteen patients were recruited and eleven were treated with either 4 mg/day baricitinib monotherapy (11) or combination therapy (4) Patients were monitored for a period of six months, and were tested for lung function, adipokines, and for KL-6 concentration, which is expressed in the lung by regenerating or injured alveolar type II cells. BARI decreased the systemic inflammation of RA by lowering expression of IL-6 and CRP and reducing ESR and serum concentrations of adiponectin. However, there was an increase in concentrations of proinflammatory adipokines (including, adipsin, resistin and leptin). Finally, KL-6 concentrations were reduced by BARI, which reflects the stability of interstitial lung involvement. In conclusion, baricitinib was demonstrated to be a safe immune modulator that reduces the concentrations biomarkers of lung fibrosis and inflammation in RA patients, including a subgroup with interstitial lung involvement.