Abstract Background/Aims JAK inhibitors have been shown to ameliorate pain as well as inflammation in patients with rheumatoid arthritis (RA). The objective of this analysis was to identify distinct pain response trajectories over 12 months in patients treated with filgotinib in FINCH 1. Methods FINCH 1 (NCT02889796) was a 52-week randomised controlled trial, in which patients with RA had an inadequate response to methotrexate. Patients reported pain on a visual analog scale (VAS), Moderate pain was defined as a VAS pain score of 40-60 mm, with scores 60 mm indicating severe pain. A group-based trajectory modelling approach was applied to identify groups of patients with similar pain response trajectories over a 12-month period. Results A total of 955 patients were included in the analysis. Among those receiving filgotinib 200 mg (n = 475), modelling produced five distinct groups of pain response trajectory. Groups A and B (45% of patients) had a rapid reduction in pain in the first 3 months, with improvements maintained over 12 months. Groups C and D (35% of patients) had a slower response but achieved a reduction in pain of approximately 50% after 6 months. Group E (20% of patients) had severe pain at baseline and persistent, moderate pain over 12 months. Median VAS pain score was 40 mm at Month 3 in Groups A, B and C (approximately 60% of patients overall) and at Month 6 in Groups A, B, C and D (80% of all patients). Median age and disease duration were similar across all groups at baseline. Lack of efficacy was the most commonly reported reason for discontinuation in Group E (10.5%); 2.1% discontinued due to adverse events. In Groups A, B, C and D, the leading reason for discontinuation was adverse events. Similar pain trajectory results were observed in patients receiving filgotinib 100 mg (n = 480). Conclusion Of patients with prior inadequate response to methotrexate treated with filgotinib 200 mg, 80% achieved a substantial reduction in pain within 6 months. Overall, these data illustrate the heterogeneity of treatment response in patients with RA and underscore the importance of communicating realistic expectations and timelines to patients. Disclosure P.C. Taylor: Consultancies; AbbVie, Acelyrin Inc., Alfasigma S.p.A., Biogen, Fresenius Kabi, Gilead, Immunovant, Lilly, Moonlake, Nordic Pharma, Pfizer, Roche, Sanofi, Takeda and UCB. Grants/research support; Alfasigma S.p.A. Y. Tanaka: Member of speakers’ bureau; AbbVie, Asahi Kasei, Astellas, AstraZeneca, Boehringer Ingelheim, Chugai, Daiichi Sankyo, Eisai, Gilead, GSK, Lilly, Pfizer, Taisho and UCB. Grants/research support; Boehringer Ingelheim, Chugai and Taisho. L. Dron: None. K. Van Beneden: Other; Employee of Alfasigma Belgium BV. T. Daud: Other; Employee of Alfasigma UK, non-author presenter. G. Burmester: Consultancies; AbbVie, BMS, Galapagos, Janssen, Lilly, Novartis, Pfizer, Sanofi and UCB. Member of speakers’ bureau; AbbVie, BMS, Galapagos, Janssen, Lilly, Novartis, Pfizer, Sanofi and UCB. B. Fautrel: Consultancies; AbbVie, Amgen, Biogen, BMS, Celltrion, Chugai, Fresenius Kabi, Galapagos, Janssen, Lilly, Medac, MSD, Nordic Pharma, Novartis, Owkin, Pfizer, Roche, Sandoz, Sanofi- Genzyme, Sobi, UCB and Viatris. Grants/research support; AbbVie, Lilly, Pfizer and Sanofi-Aventis.
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