Evaluation of the Safety Profile of Baricitinib in Patients with Rheumatoid Arthritis: Meta-analysis of Clinical Trials

Detalhes bibliográficos
Autor(a) principal: Abrunheiro, Nuno Alexandre
Data de Publicação: 2021
Outros Autores: Alves, Carlos, Batel Marques, Francisco
Tipo de documento: Artigo
Idioma: por
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: https://doi.org/10.25756/rpf.v13i1.266
Resumo: Introduction: Baricitinib, a selective inhibitor of janus kinase (JAK) - JAK1 and JAK2, is one of the most recent approved therapeutic alternatives for patients with rheumatoid arthritis (RA). This study is aimed at conducting a meta-analysis to assess the safety profile of baricitinib, at the doses of 2 mg and 4 mg, when compared with placebo.Methods: A literature review was conducted in the PubMed and Clinicaltrails.gov databases. Software RevMan, version 5.3, was used to estimate the relative risk (RR) and 95% confidence intervals (CIs), using the Mantel-Haenszel random effects model.Results: The meta-analysis included 6 randomized clinical trials evaluating baricitinib in adult patients with RA. Baricitinib 2 mg did not increase the risk of total adverse events (RR: 1.01, 95% CI: 0.92-1.11, p = 0.80), serious adverse events (RR: 0.69, 95% CI: 0.38-1.25, p = 0.22), severe infections (RR: 0.97, 95% CI: 0.28-3.37, p = 0.96) nor herpes zoster (RR: 2.32, 95% CI: 0.27-19.93, p = 0.44). Baricitinib 4 mg did not increase the risk of serious adverse events (RR: 1.11, 95% CI: 0.77-1.60, p = 0.58) nor serious infections (RR: 1.00, 95% CI: 0.51-1.96, p = 1.00). However, it was identified an increased risk of total adverse events (RR: 1.14, 95% CI: 1.04-1.24, p = 0.005) and herpes zoster (RR: 3.81, 95% CI: 1.35-10.71, p = 0.01) in patients treated with baricitinib 4 mg when compared to placebo.Conclusion: The results of this meta-analysis identified increased risks of total adverse events and herpes zoster associated with baricitinib 4 mg, when compared with placebo. No new risks have been identified.
id RCAP_2332cb4232bd5aa3dbf41f2a129cc645
oai_identifier_str oai:ojs.farmacoterapia.pt:article/312
network_acronym_str RCAP
network_name_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository_id_str 7160
spelling Evaluation of the Safety Profile of Baricitinib in Patients with Rheumatoid Arthritis: Meta-analysis of Clinical TrialsAvaliação do Perfil de Segurança do Baricitinib em Doentes com Artrite Reumatoide: Meta-análise de Ensaios ClínicosIntroduction: Baricitinib, a selective inhibitor of janus kinase (JAK) - JAK1 and JAK2, is one of the most recent approved therapeutic alternatives for patients with rheumatoid arthritis (RA). This study is aimed at conducting a meta-analysis to assess the safety profile of baricitinib, at the doses of 2 mg and 4 mg, when compared with placebo.Methods: A literature review was conducted in the PubMed and Clinicaltrails.gov databases. Software RevMan, version 5.3, was used to estimate the relative risk (RR) and 95% confidence intervals (CIs), using the Mantel-Haenszel random effects model.Results: The meta-analysis included 6 randomized clinical trials evaluating baricitinib in adult patients with RA. Baricitinib 2 mg did not increase the risk of total adverse events (RR: 1.01, 95% CI: 0.92-1.11, p = 0.80), serious adverse events (RR: 0.69, 95% CI: 0.38-1.25, p = 0.22), severe infections (RR: 0.97, 95% CI: 0.28-3.37, p = 0.96) nor herpes zoster (RR: 2.32, 95% CI: 0.27-19.93, p = 0.44). Baricitinib 4 mg did not increase the risk of serious adverse events (RR: 1.11, 95% CI: 0.77-1.60, p = 0.58) nor serious infections (RR: 1.00, 95% CI: 0.51-1.96, p = 1.00). However, it was identified an increased risk of total adverse events (RR: 1.14, 95% CI: 1.04-1.24, p = 0.005) and herpes zoster (RR: 3.81, 95% CI: 1.35-10.71, p = 0.01) in patients treated with baricitinib 4 mg when compared to placebo.Conclusion: The results of this meta-analysis identified increased risks of total adverse events and herpes zoster associated with baricitinib 4 mg, when compared with placebo. No new risks have been identified.Introdução: O baricitinib, uma das mais recentes alternativas terapêuticas para doentes com artrite reumatoide (AR), é um inibidor seletivo da janus quinase (JAK) – JAK1 e JAK2. Este estudo teve como objetivo realizar uma meta-análise de forma a avaliar o perfil de segurança do baricitinib nas doses de 2 e 4 mg, tendo por base a comparação com o placebo.Métodos: Recorreu-se às bases de dados PubMed e Clinicaltrails.gov para efetuar a pesquisa bibliográfica. Foi utilizado o programa RevMan versão 5.3 para calcular o risco relativo (RR) e intervalos de confiança de 95% (ICs) para todos os resultados ao longo da meta-análise, usando o modelo dos efeitos aleatórios Mantel-Haenszel.Resultados: Foram selecionados seis ensaios clínicos aleatorizados que avaliaram a segurança do baricitinib em doentes adultos com AR. O baricitinib 2 mg demonstrou não aumentar os eventos adversos totais (RR: 1,01; 95% IC: 0,92-1,11; p=0,80), os eventos adversos graves (RR: 0,69; 95% IC: 0,38-1,25; p=0,22), as infeções graves (RR: 0,97; 95% IC: 0,28-3,37; p=0,96) nem de herpes zoster (RR: 2,32; 95% IC: 0,27-19,93; p=0,44). O baricitinib 4 mg também não aumentou o risco de eventos adversos graves (RR: 1,11; 95% IC: 0,77-1,60; p=0,58), de infeções graves (RR: 1,00; 95% IC: 0,51-1,96; p=1,00) ou de eventos cardiovasculares graves (RR: 1,16; 95% IC 0,24-5,48; p=0,85). No entanto, existiu uma tendência de aumento dos eventos adversos totais (RR: 1,14; 95% IC: 1,04-1,24; p=0,005) e de herpes zoster (RR: 3,81; 95% IC: 1,35-10,71; p=0,01) comparativamente ao placebo.Conclusão: Os resultados desta meta-análise de ensaios clínicos demonstraram a dose mais elevada de baricitinib, 4 mg aumenta o risco de reações adversas totais e de herpes zoster face a placebo. Não foram identificados riscos acrescidos de novas reações adversas.Formifarma2021-07-23info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttps://doi.org/10.25756/rpf.v13i1.266https://doi.org/10.25756/rpf.v13i1.266Revista Portuguesa de Farmacoterapia / Portuguese Journal of Pharmacotherapy; Vol 13 No 1 (2021): Janeiro/Fevereiro/Março; 19-29Revista Portuguesa de Farmacoterapia; v. 13 n. 1 (2021): Janeiro/Fevereiro/Março; 19-292183-73411647-354Xreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAPporhttp://revista.farmacoterapia.pt/index.php/rpf/article/view/312http://revista.farmacoterapia.pt/index.php/rpf/article/view/312/289Direitos de Autor (c) 2021 Revista Portuguesa de Farmacoterapiahttp://creativecommons.org/licenses/by-nc-nd/4.0info:eu-repo/semantics/openAccessAbrunheiro, Nuno AlexandreAlves, CarlosBatel Marques, Francisco2023-09-01T04:35:06Zoai:ojs.farmacoterapia.pt:article/312Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T15:11:42.220151Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Evaluation of the Safety Profile of Baricitinib in Patients with Rheumatoid Arthritis: Meta-analysis of Clinical Trials
Avaliação do Perfil de Segurança do Baricitinib em Doentes com Artrite Reumatoide: Meta-análise de Ensaios Clínicos
title Evaluation of the Safety Profile of Baricitinib in Patients with Rheumatoid Arthritis: Meta-analysis of Clinical Trials
spellingShingle Evaluation of the Safety Profile of Baricitinib in Patients with Rheumatoid Arthritis: Meta-analysis of Clinical Trials
Abrunheiro, Nuno Alexandre
title_short Evaluation of the Safety Profile of Baricitinib in Patients with Rheumatoid Arthritis: Meta-analysis of Clinical Trials
title_full Evaluation of the Safety Profile of Baricitinib in Patients with Rheumatoid Arthritis: Meta-analysis of Clinical Trials
title_fullStr Evaluation of the Safety Profile of Baricitinib in Patients with Rheumatoid Arthritis: Meta-analysis of Clinical Trials
title_full_unstemmed Evaluation of the Safety Profile of Baricitinib in Patients with Rheumatoid Arthritis: Meta-analysis of Clinical Trials
title_sort Evaluation of the Safety Profile of Baricitinib in Patients with Rheumatoid Arthritis: Meta-analysis of Clinical Trials
author Abrunheiro, Nuno Alexandre
author_facet Abrunheiro, Nuno Alexandre
Alves, Carlos
Batel Marques, Francisco
author_role author
author2 Alves, Carlos
Batel Marques, Francisco
author2_role author
author
dc.contributor.author.fl_str_mv Abrunheiro, Nuno Alexandre
Alves, Carlos
Batel Marques, Francisco
description Introduction: Baricitinib, a selective inhibitor of janus kinase (JAK) - JAK1 and JAK2, is one of the most recent approved therapeutic alternatives for patients with rheumatoid arthritis (RA). This study is aimed at conducting a meta-analysis to assess the safety profile of baricitinib, at the doses of 2 mg and 4 mg, when compared with placebo.Methods: A literature review was conducted in the PubMed and Clinicaltrails.gov databases. Software RevMan, version 5.3, was used to estimate the relative risk (RR) and 95% confidence intervals (CIs), using the Mantel-Haenszel random effects model.Results: The meta-analysis included 6 randomized clinical trials evaluating baricitinib in adult patients with RA. Baricitinib 2 mg did not increase the risk of total adverse events (RR: 1.01, 95% CI: 0.92-1.11, p = 0.80), serious adverse events (RR: 0.69, 95% CI: 0.38-1.25, p = 0.22), severe infections (RR: 0.97, 95% CI: 0.28-3.37, p = 0.96) nor herpes zoster (RR: 2.32, 95% CI: 0.27-19.93, p = 0.44). Baricitinib 4 mg did not increase the risk of serious adverse events (RR: 1.11, 95% CI: 0.77-1.60, p = 0.58) nor serious infections (RR: 1.00, 95% CI: 0.51-1.96, p = 1.00). However, it was identified an increased risk of total adverse events (RR: 1.14, 95% CI: 1.04-1.24, p = 0.005) and herpes zoster (RR: 3.81, 95% CI: 1.35-10.71, p = 0.01) in patients treated with baricitinib 4 mg when compared to placebo.Conclusion: The results of this meta-analysis identified increased risks of total adverse events and herpes zoster associated with baricitinib 4 mg, when compared with placebo. No new risks have been identified.
publishDate 2021
dc.date.none.fl_str_mv 2021-07-23
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv https://doi.org/10.25756/rpf.v13i1.266
https://doi.org/10.25756/rpf.v13i1.266
url https://doi.org/10.25756/rpf.v13i1.266
dc.language.iso.fl_str_mv por
language por
dc.relation.none.fl_str_mv http://revista.farmacoterapia.pt/index.php/rpf/article/view/312
http://revista.farmacoterapia.pt/index.php/rpf/article/view/312/289
dc.rights.driver.fl_str_mv Direitos de Autor (c) 2021 Revista Portuguesa de Farmacoterapia
http://creativecommons.org/licenses/by-nc-nd/4.0
info:eu-repo/semantics/openAccess
rights_invalid_str_mv Direitos de Autor (c) 2021 Revista Portuguesa de Farmacoterapia
http://creativecommons.org/licenses/by-nc-nd/4.0
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Formifarma
publisher.none.fl_str_mv Formifarma
dc.source.none.fl_str_mv Revista Portuguesa de Farmacoterapia / Portuguese Journal of Pharmacotherapy; Vol 13 No 1 (2021): Janeiro/Fevereiro/Março; 19-29
Revista Portuguesa de Farmacoterapia; v. 13 n. 1 (2021): Janeiro/Fevereiro/Março; 19-29
2183-7341
1647-354X
reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv
_version_ 1799129987102539776