LONG-TERM results from the RA-BEYOND study showcase encouraging news for patients with rheumatoid arthritis (RA) aiming to reduce medication burden. The study assessed whether individuals who had achieved sustained disease control on baricitinib 4 mg daily could maintain this control after stepping down to a 2 mg dose.
In this phase III long-term extension (LTE) trial, patients who had been stable on baricitinib 4 mg for at least 15 months were randomly assigned to either continue at 4 mg or taper to 2 mg. After 96 weeks, 59.9% of those in the 2 mg group maintained low disease activity (LDA), compared to 70.2% in the 4 mg group. Remission was maintained in 30.8% and 36.6% of patients in the 2 mg and 4 mg arms, respectively.
While slightly more patients in the 2 mg group required rescue therapy (22.5% vs 14.7%), the majority regained disease control upon returning to the 4 mg dose. Specifically, over 75% of rescued patients recaptured LDA within 12 to 24 weeks.
The study suggests that dose tapering may be a viable option for many patients in sustained remission or low disease activity, offering a balance between treatment efficacy and long-term medication management. The option to recapture disease control following dose increase further supports a flexible, patient-tailored approach to RA care.
Aleksandra Zurowska, EMJ
Reference
Edwards et al. Baricitinib Dose Reduction in Patients With Rheumatoid Arthritis Achieving Sustained Disease Control: Final Results From the RA-BEYOND Study. J Rheumatol. 2025;52(4): 316-22.
