Abstract | Background: Methods: In this Phase 2, double-blind, dose-ranging study, participants were randomized 1:1:1:1:1 to receive placebo or baricitinib (0.75 mg daily; 0.75 mg twice daily; 1.5 mg daily; or 4 mg daily), for 24 weeks followed by 4-8 weeks of washout. Results: Participants (N = 129) were 63±9.1 (mean±standard deviation) years of age, 27.1% (35/129) women and 11.6% (15/129) African-American race. Baseline hemoglobin A1c (HbA1c) was 7.3±1% and estimated glomerular filtration rate was 45.0±12.1 mL/min/1.73 m2 with first morning urine albumin- creatinine ratio (UACR) of 820 (407-1632) (median; interquartile range) mg/g. Baricitinib, 4 mg daily, decreased morning UACR by 41% at Week 24 compared with placebo (ratio to baseline 0.59, 95% confidence interval 0.38-0.93, P = 0.022). UACR was decreased at Weeks 12 and 24 and after 4-8 weeks of washout. Baricitinib 4 mg decreased inflammatory biomarkers over 24 weeks (urine C-X-C motif chemokine 10 and urine C-C motif ligand 2, plasma soluble tumor necrosis factor receptors 1 and 2, intercellular adhesion molecule 1 and serum amyloid A). The only adverse event rate that differed between groups was anemia at 32.0% (8/25) for baricitinib 4 mg daily versus 3.7% (1/27) for placebo. Conclusions:
|
Authors | Katherine R Tuttle, Frank C Brosius 3rd, Sharon G Adler, Matthias Kretzler, Ravindra L Mehta, James A Tumlin, Yoshiya Tanaka, Masakazu Haneda, Jiajun Liu, Maria E Silk, Tracy E Cardillo, Kevin L Duffin, Joseph V Haas, William L Macias, Fabio P Nunes, Jonathan M Janes |
Journal | Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association
(Nephrol Dial Transplant)
Vol. 33
Issue 11
Pg. 1950-1959
(11 01 2018)
ISSN: 1460-2385 [Electronic] England |
PMID | 29481660
(Publication Type: Clinical Trial, Phase II, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
|
Chemical References |
- Azetidines
- Protein Kinase Inhibitors
- Purines
- Pyrazoles
- Sulfonamides
- JAK1 protein, human
- JAK2 protein, human
- Janus Kinase 1
- Janus Kinase 2
- baricitinib
|
Topics |
- Albuminuria
(drug therapy, etiology, pathology)
- Azetidines
(therapeutic use)
- Diabetes Mellitus, Type 2
(physiopathology)
- Diabetic Nephropathies
(complications)
- Double-Blind Method
- Female
- Gene Expression Regulation, Enzymologic
(drug effects)
- Glomerular Filtration Rate
- Humans
- Janus Kinase 1
(antagonists & inhibitors)
- Janus Kinase 2
(antagonists & inhibitors)
- Male
- Middle Aged
- Prognosis
- Protein Kinase Inhibitors
(therapeutic use)
- Purines
- Pyrazoles
- Sulfonamides
(therapeutic use)
|