Eli Lilly and Company (NYSE: LLY) and Incyte Corporation (Nasdaq: INCY) announced the presentation of 12-week results from a Phase IIb study of baricitinib, formerly LY3009104 (INCB28050), an orally available janus kinase (JAK) inhibitor, in patients with active rheumatoid arthritis (RA). The results were presented as a late-breaking oral presentation at the European League Against Rheumatism's (EULAR) Annual European Congress of Rheumatology [EULAR abstract LB0005: 12-Week Results of a Phase IIb Dose-Ranging Study of LY3009104 (INCB028050), an Oral JAK1/JAK2 Inhibitor, in Combination with Traditional DMARDs in Patients with Rheumatoid Arthritis].
The Phase IIb randomized double-blind, placebo-controlled, dose-ranging study, known as JADA, involved a total of 301 patients with active RA on stable doses of methotrexate. Patients were randomized to receive either placebo or one of four once-daily doses of baricitinib (1 mg, 2 mg, 4 mg or 8 mg) for 12 weeks.
Primary Endpoint Achieved
The Phase IIb trial achieved the primary endpoint by demonstrating a statistically significant difference in the American College of Rheumatology 20 (ACR20) response between the combined 4 mg and 8 mg baricitinib groups (76 percent) compared with placebo (41 percent) after 12 weeks of treatment (p<0.001). Statistically significant improvement was observed at the first assessment point after two weeks of treatment and was sustained through week 12.
Summary of Secondary Endpoints
A statistically significant difference in response for the ACR20, ACR50 and ACR70 secondary endpoints was observed with the 1 mg, 4 mg and 8 mg dose groups compared with placebo.
- 8 mg: 78 percent (p<0.001)
- 4 mg: 75 percent (p<0.001)
- 2 mg: 54 percent (not significant)
- 1 mg: 57 percent (p<0.05)
- Placebo: 41 percent
- 8 mg: 40 percent (p<0.001)
- 4 mg: 35 percent (p<0.001)
- 2 mg: 17 percent (not significant)
- 1 mg: 31 percent (p<0.05)
- Placebo: 10 percent
- 8 mg: 20 percent (p<0.001)
- 4 mg: 23 percent (p<0.001)
- 2 mg: 8 percent (not significant)
- 1 mg: 12 percent (p<0.05)
- Placebo: 2 percent
The most common treatment-emergent adverse event class was infections, with a similar rate observed among patients in the placebo group (12 percent) and patients receiving baricitinib (14 percent). One patient in the placebo group was diagnosed with an opportunistic infection of toxocariasis. No deaths or opportunistic infections occurred in the active treatment groups.
There were seven serious adverse events reported in six patients (two events in the placebo group, four in the 2 mg group and one in the 8 mg group). Dose-dependent changes in laboratory tests (hemoglobin, neutrophil, serum creatinine, LDL and HDL) were observed, with greater changes being observed in the 8 mg baricitinib group.
Eli Lilly and Company; Incyte Corporation