Achieving pain control in early rheumatoid arthritis with baricitinib monotherapy or in combination with methotrexate versus methotrexate monotherapy

RMD Open. 2022;8(1):e001994 doi: 10.1136/rmdopen-2021-001994

Post hoc analysis of the RA-BEGIN trial finds that, over a one-year period, patients treated with baricitinib (monotherapy or in combination with methotrexate [MTX]) report greater pain relief and a more rapid attainment of clinically meaningful thresholds of pain improvement, than patients who receive MTX monotherapy.Often overlooked, when treating RA solely to a disease activity target, patient-reported pain is common in RA, even in those reaching inflammatory remission. The fact that pain persists under these circumstances suggests that the underlying mechanism for pain is not solely related to inflammation. Consequently, therapeutics effective in limiting inflammation of RA may have additional direct action on non-inflammatory pain mechanisms.To this end, Taylor, et al. assessed speed, magnitude and maintenance of pain improvement in patients with RA (naïve to DMARDs) receiving either baricitinib, baricitinib and MTX, or MTX alone over one year.