Baricitinib y tofacitinib en pacientes con artritis reumatoide: resultados de práctica clínica habitual / Baricitinib and tofacitinib in patients with rheumatoid arthritis: results of regular clinical practice

Objetivo: Objetivo principal: describir la efectividad y seguridad debaricitinib y tofacitinib en pacientes diagnosticados de artritis reumatoideen nuestro centro. Objetivo secundario: analizar si existen diferenciasentre ambos fármacos en práctica clínica real.Método: Estudio observacional retrospectivo de 2 años de duraciónque incluyó pacientes diagnosticados de artritis reumatoide en tratamientocon baricitinib o tofacitinib en nuestro centro durante al menos 6 meses.Bases de datos: historia clínica electrónica, aplicativo informático dedispensación a pacientes externos. Variables recogidas: demográficas,factores de mal pronóstico, tratamiento previo, duración de tratamiento,tratamiento concomitante, escala DAS28, número de articulaciones inflamadas y dolorosas, escala visual analógica del dolor, suspensión deltratamiento y reacciones adversas. Evaluación de la efectividad: disminución en la escala DAS28, articulaciones inflamadas y dolorosas y escalavisual analógica del dolor a los 6 y 12 meses de iniciado el tratamiento.Evaluación de la seguridad: detección de reacciones adversas. Análisisestadístico: prueba t-student.Resultados: Se evaluaron 44 pacientes, 20 (70% mujeres) recibierontratamiento con baricitinib, 24 (95,8% mujeres) con tofacitinib. Baricitinibredujo la puntuación en la escala DAS28 en 2,3 y 1,7 a los 6 y 12 meses.Tofacitinib en 2 y 1,9 respectivamente. Baricitinib redujo el número de articulaciones inflamadas y dolorosas en 7 a los 6 y 12 meses, tofacitinib en 4 las inflamadas y 6 las dolorosas. Baricitinib redujo la puntuación en la escala visual analógica del dolor en 7,8 y 6,8; tofacitinib en5 y 6 a los 6 y 12 meses. El 40% de los pacientes con baricitinib y el62,5% con tofacitinib precisaron tratamiento con corticoides. El 10% delos pacientes con baricitinib y el 25% de los pacientes con tofacitinibsuspendieron el tratamiento por ineficacia. (AU)

Objective: Main objective: Describe the effectiveness and safety ofbaricitinib and tofacitinib in patients diagnosed with rheumatoid arthritis inour hospital. Secondary objective: Analyse whether there are differencesbetween the two drugs in routine clinical practice.Method: Two-year retrospective study of patients diagnosed with rheumatoid arthritis treated in our hospital with baricitinib and tofacitinib forat least 6 months. Databases: Electronic medical record and outpatientmedication dispensing software. Variables collected: Demographic variables, poor prognosis factors, previous treatment, duration of treatment,concomitant treatment, DAS28, number of swollen and painful joints, painvisual analogy scale, treatment discontinuation, and adverse reactions.Effectiveness evaluation: Decreases in the DAS28 scale, the number ofswollen and painful joints, and the pain Visual Analogy Scale at 6 monthsand 12 months after starting treatment. Safety evaluation: Detection ofadverse reactions. Statistical analysis: Student t-test.Results: A total of 44 patients were evaluated. Of these, 20 (70% women)received treatment with baricitinib and 24 (95.8% women) received tofacitinib. Baricitinib reduced the DAS28 by 2.3 and 1.7 at 6 months and12 months, respectively, and tofacitinib reduced the scale by 2 and 1.9 at6 months and 12 months, respectively. Baricitinib reduced the numberof swollen and painful joints by 7 at both 6 months and 12 months, and tofacitinib reduced the number of swollen and painful joints by 4 and 6at 6 months and 12 months, respectively. Baricitinib reduced the VisualAnalogy Scale score by 7.8 and 6.8 at 6 months and 12 months, respectively, and tofacitinib reduced the score by 5 and 6 at 6 months and12 months, respectively. (AU)

Baricitinib and tofacitinib in patients with rheumatoid arthritis: results of regular clinical practice.

OBJECTIVE: Main objective: Describe the effectiveness and safety of baricitinib and tofacitinib in patients diagnosed with rheumatoid arthritis in our hospital. SECONDARY OBJECTIVE: Analyse whether there are  differences between the two drugs in routine clinical practice. METHOD: Two-year retrospective study of patients diagnosed with  rheumatoid arthritis treated in our hospital with baricitinib and tofacitinib  for at least 6 months. Databases: Electronic medical record and outpatient medication dispensing software. Variables collected:  Demographic variables, poor prognosis factors, previous treatment,  duration of treatment, concomitant treatment, DAS28, number of swollen  and painful joints, pain visual analogy scale, treatment discontinuation,  and adverse reactions. Effectiveness evaluation: Decreases in the DAS28  scale, the number of swollen and painful joints, and the pain Visual  Analogy Scale at 6 months and 12 months after starting treatment. Safety evaluation: Detection of adverse reactions. STATISTICAL ANALYSIS: Student t- test. RESULTS: A total of 44 patients were evaluated. Of these, 20 (70%  women) received treatment with baricitinib and 24 (95.8% women)  received tofacitinib. Baricitinib reduced the DAS28 by 2.3 and 1.7 at 6  months and 12 months, respectively, and tofacitinib reduced the scale by 2 and 1.9 at 6 months and 12 months, respectively. Baricitinib reduced the  number of swollen and painful joints by 7 at both 6 months and 12  months, and tofacitinib reduced the number of swollen and painful joints  by 4 and 6 at 6 months and 12 months, respectively. Baricitinib reduced  the Visual Analogy Scale score by 7.8 and 6.8 at 6 months and 12 months, respectively, and tofacitinib reduced the score by 5 and 6 at 6 months and 12 months, respectively. Corticosteroid treatment was needed in 40% of patients treated with baricitinib and 62.5% of patients treated with  rofacitinib. Treatment was discontinued due to loss of effectiveness in 10% of patients receiving baricitinib and 25% of patients treated with  tofacitinib. Adverse reactions were experienced by 10% of patients treated with baricitinib and 12.5% of patients treated with tofacitinib. Adverse  reactions led to treatment discontinuation in only 1 patient in each group.  No statistically significant differences were observed between the two  drugs. CONCLUSIONS: The results show that baricitinib and tofacitinib were  effective and safe in relation to all the variables analysed. Moreover, both drugs were similar in terms of effectiveness and safety for the  treatment of rheumatoid arthritis in real-world clinical practice.

Objetivo: Objetivo principal: describir la efectividad y seguridad de baricitinib y tofacitinib en pacientes diagnosticados de artritis  reumatoide en nuestro centro. Objetivo secundario: analizar si existen  diferencias entre ambos fármacos en práctica clínica real.Método: Estudio observacional retrospectivo de 2 años de duración que  incluyó pacientes diagnosticados de artritis reumatoide en tratamiento con  baricitinib o tofacitinib en nuestro centro durante al menos 6 meses. Bases de datos: historia clínica electrónica, aplicativo informático de dispensación a pacientes externos. Variables recogidas: demográficas, factores de mal  pronóstico, tratamiento previo, duración de tratamiento, tratamiento  concomitante, escala DAS28, número de articulaciones inflamadas y  dolorosas, escala visual analógica del dolor, suspensión del tratamiento y  reacciones adversas. Evaluación de la efectividad: disminución en la escala DAS28, articulaciones inflamadas y dolorosas y escala visual analógica del  dolor a los 6 y 12 meses de iniciado el tratamiento. Evaluación de la  seguridad: detección de reacciones adversas.Análisis estadístico: prueba t-student.Resultados: Se evaluaron 44 pacientes, 20 (70% mujeres) recibieron tratamiento con baricitinib, 24 (95,8% mujeres) con tofacitinib.  Baricitinib redujo la puntuación en la escala DAS28 en 2,3 y 1,7 a los 6 y  12 meses. Tofacitinib en 2 y 1,9 respectivamente. Baricitinib redujo el  número de articulaciones inflamadas y dolorosas en 7 a los 6 y 12 meses,  tofacitinib en 4 las inflamadas y 6 las dolorosas. Baricitinib redujo la  puntuación en la escala visual analógica del dolor en 7,8 y 6,8; tofacitinib  en 5 y 6 a los 6 y 12 meses. El 40% de los pacientes con baricitinib y el 62,5% con tofacitinib precisaron tratamiento con corticoides. El 10% de los pacientes con baricitinib y el 25% de los pacientes con tofacitinib suspendieron el tratamiento por ineficacia. El 10% de los pacientes de baricitinib y el 12,5% de tofacitinib experimentaron reacciones adversas. Sólo un paciente de cada grupo suspendió el tratamiento por reacciones adversas. No se observaron diferencias estadísticamente significativas entre ambos fármacos.Conclusiones: Según nuestros resultados, baricitinib y tofacitinib han demostrado ser efectivos y seguros en todas las variables analizadas. Además, ambos fármacos resultaron similares en efectividad y  seguridad en la práctica clínica habitual del tratamiento de la artritis  reumatoide.

Postsynthetic modifications of [2,2,2-(H)(PPh3)2-closo-2,1-RhSB8H8] with Lewis bases: cluster modular tuning.

It has been demonstrated that the reaction of [2,2,2-(H)(PPh3)2-closo-2,1-RhSB8H8] () with PPh3 affords the boron substituted rhodathiaborane-PPh3 adduct, [6,6-(PPh3)2-9-(PPh3)-arachno-6,5-RhSB8H9] (). Building upon this reaction, we report herein that the 10-vertex hydridorhodathiaborane reacts with the Lewis bases, PCy3, py, 2-Mepy, 2-Etpy, 3-Mepy and 4-Mepy to form the rhodathiaborane-ligand adducts, [6,6-(PPh3)2-9-(L)-arachno-6,5-RhSB8H9], where L = PCy3 (), 2-Mepy (), 2-Etpy (), py (), 3-Mepy () or 4-Mepy (), and [8,9-µ-(H)-9-(PPh3)2-8-(L)-arachno-9,6-RhSB8H8], where L = py (), 3-Mepy () or 4-Mepy (). The selectivity of the reactions depended on the nature of the entering Lewis bases, affording the 6,5-isomers, , , and as single products for PPh3, PCy3, 2-Mepy and 2-Etpy; and mixtures of the 6,5-/9,6-regioisomers, /, / and / for py, 3-Mepy and 4-Mepy, respectively. The molecular structures of both regioisomers were characterized by X-ray diffraction analysis for the 6,5-isomers, and , and for the 9,6-isomers, and . Variable temperature NMR studies of the reaction between and PPh3 or 2-Mepy demonstrated that at low temperatures there is formation of the 9,6-species that subsequently isomerizes to the 6,5-regioisomer, indicating that for the more sterically hindered Lewis bases, PPh3, 2-Mepy and PCy3, the latter isomer is more stable and accessible through an intramolecular {Rh(PPh3)2} vertex flip. The formation of both isomers with py, 3-Mepy and 4-Mepy indicates that the kinetic and thermodynamic energies of the 6,5 and 9,6 rhodathiaborane-ligand adducts are similar for these Lewis bases. Lewis base bonding to exo-polyhedral boron vertices results in a change of the metal coordination from pseudo-octahedral Rh(iii) in to pseudo-square planar Rh(i) in the adducts. The chemistry described here highlights the remarkable structural flexibility of these polyhedral boron-containing compounds, their modular architecture and their easy postsynthetic modification.

Rhodathiaborane reaction cycles driven by C2H4 and H2: synthesis and characterization of [(H)2(PPh3)RhSB8H7(PPh3)] and [(η(2)-C2H4)(PPh3)RhSB8H7(PPh3)].

New 10-vertex rhodathiaboranes are reported to exhibit reversible reaction chemistry leading to the formation of stoichiometric cycles driven by oxidation/reduction chemistry of the polyhedral boron-based clusters with ethelyne and dihydrogen.

Facile two-electron reduction of a closo-rhodathiadecaborane.

Closo-to-arachno redox flexibility in metallaheteroboranes may be viewed as a metal-to-ligand cooperative action with application in catalysis. The treatment of [PSH][arachno-4-SB(8)H(11)] with [RhCl(PPh(3))(3)] affords, after chromatography, three new 10-vertex rhodathiaboranes, [2,2,2-(H)(PPh(3))(2)-closo-2,1-RhSB(8)H(8)] (3), [6,6,9-(PPh(3))(3)-arachno-6,5-RhSB(8)H(9)] (4) and [2,2,2-(Cl)(H)(PPh(3))-6-(PPh(3))-closo-2,1-RhSB(8)H(7)] (5). 3 reacts quantitatively with PPh(3) to form 4, which, in turn, reacts with chlorinated solvents to give the chloro-ligated cluster 5. Kinetic studies demonstrate that the reaction of 3 with PPh(3) obeys a second-order rate law, with an associative mechanism. The Lewis acidity of 3 is quite remarkable, and, given its closo-to-arachno structural and electronic response, this cluster is expected to exhibit a rich chemistry.