Thrombotic Markers in Plasma as Predictors of Response in Rheumatoid Arthritis Patients Treated with Baricitinib – Pilot Observation

Felis-Giemza, Anna; Chmurzynska, Kornelia; Wronski, Jakub; Klimek, Paulina; Kornatka, Anna; Maslinski, Wlodzimierz; Ciechomska, Marzena; Massalska, Magdalena

doi:10.2478/aite-2025-0010

Figures & Tables

Thrombotic parameters DD (a), fibrinogen (b), homocysteine (c), ATIII (d), TT (e), APTT (f), PT (g) and INR (h) detected in RA patients (before and 3 months after treatment with baricitinib) in comparison with HC. *p < 0.05,**p < 0.01, ***p < 0.001. ATIII, antithrombin III; APTT, activated partial thromboplastin time; DD, D-dimer; HC, healthy controls; INR, international normalized ratio; JAKi, Janus kinase inhibitor; PT, prothrombin time; RA, rheumatoid arthritis; TT, thrombin time.

Thrombotic parameters DD (a), fibrinogen (b), homocysteine (c) and ATIII (d) detected in RA patients according to response to baricitinib (before and 3 months after treatment). *p < 0.05, **p < 0.01,****p < 0.0001. ATIII, antithrombin III; DD, D-dimer; HC, healthy controls; JAKi, Janus kinase inhibitor; ns, not significant; RA, rheumatoid arthritis.

Correlation and p-value heatmap analysis between ESR before and after, CRP before and after, ATIII before and after, and DD before and after baricitinib therapy. p-values were expressed as follows: *0.05 > p > 0.01, **0.01 > p > 0.001, ***p < 0.001. ATIII, antithrombin III; CRP, C-reactive protein; DD, D-dimer; ESR, erythrocyte sedimentation rate; ns, not significant.

Clinical characteristics of patients with RA treated with baricitinib: GR and MR

	Month 0		Month 3
	GR, n = 8	MR, n = 10	GR, n = 8	MR, n = 10
DAS28-ESR	5.52 ± 0.2 (5.1–6.9)	6.1 ± 0.3 (5.1–8.2)	2.8 ± 0.1 (2.2–3.1)	4.2 ± 0.2 (3.3–5.0)
VAS, activity (mm)	78.1 ± 4.7 (52.0–95.0)	74.1 ± 4.2 (63.0–91.0)	30.1 ± 2.6 (17.0–41.0)	50.3 ± 5.4 (28.0–82.0)
Joints, painful (n)	13.0 ± 1.7 (6–24)	13.1 ± 2.1 (6–24)	2.1 ± 0.4 (0–4)	3.0 ± 1.0 (0–10)
Joints, tender (n)	7.0 ± 1.2 (2–13)	7.5 ± 2.1 (1–22)	0.4 ± 0.2 (0–2)	1.5 ± 0.8 (0–8)
CRP (mg/dL)	12.5 ± 6.1 (1.0–45.0)	31.2 ± 11.8 (2.0–132)	3.0 ± 0.9 (0.2–7.0)	11.9 ± 5.8 (1.0–62.5)
ESR (mm/h)	18.12 ± 6.3 (5.0–60.0)	33.0 ± 7.8 (5.0–94.0)	11.9 ± 4.3 (4.0–44.0)	43.8 ± 11.0 (8.0–120.0)
DD (ng/mL)	1263.75 ± 410.1 (240.0–3757.0)	1639.2 ± 550.5 (386.0–6381.0)	636.8 ± 114.5 (105.0–2379.0)	1149.8 ± 336.8 (105.0–3279.0)
Fibrinogen (mg/dL)	389.6 ± 48.8 (239.0–614.0)	427.1 ± 37.6 (284.0–671.0)	377.13 ± 33.1 (295.0–552.0)	401.10 ± 36.5 (261.0–581.0)
HCY (µmol/L)	9.7 ± 0.7 (7.2–11.9)	8.7 ± 0.7 (3.3–10.4)	11.4 ± 0.6 (8.2–13.5)	10.2 ± 0.9 (5.4–13.6)
ATIII (%)	117.6 ± 5.2 (100.0–138.0)	105.3 ± 3.6 (94.0–119.0)	129.0 ± 3.0 (121.0–141.0)	113.50 ± 3.2 (94.0–135.0)
TT (s)	11.48 ± 0.3 (10.6–12.8)	10.88 ± 0.4 (9.8–14.7)	10.83 ± 0.5 (8.5–12.6)	12.13 ± 0.6 (9.2–15.6)
APTT (s)	31.0 ± 1.1 (27.4–35.7)	31.1 ± 0.9 (27.4–35.7)	30.25 ± 0.6 (27.8–32.4)	33.14 ± 1.0 (28.2–39.2)
PT (s)	11.7 ± 0.2 (11.1–12.5)	11.9 ± 0.4 (9.6–13.7)	11.7 ± 0.3 (10.8–13.2)	12.1 ± 0.3 (10.9–14.2)
INR	1.11 ± 0.02 (1.05–1.18)	1.12 ± 0.04 (0.91–1.29)	1.1 ± 0.03 (1.02–1.24)	1.14 ± 0.03 (1.03–1.34)

Correlation between the chosen parameters of thrombosis and clinical data

Before treatment		r	p-value
ATIII	DAS28	–0.696	0.003
ATIII	CRP	–0.599	0.013
ATIII	ESR	–0.572	0.018
ATIII	RF	–0.601	0.012
ATIII	DD	–0.554	0.023
DD	DAS28	0.526	0.025
DD	CRP	0.65	0.003
DD	ESR	0.642	0.004
DD	RF	0.582	0.011
DD	Fibrinogen	0.623	0.006
DD	Homocysteine	0.540	0.021
Fibrinogen	CRP	0.721	0.001
Fibrinogen	ESR	0.800	<0.001
Fibrinogen	RF	0.529	0.024
Fibrinogen	ATIII	–0.513	0.035
TT	CRP	–0.631	0.005
TT	ESR	–0.575	0.013
TT	RF	–0.574	0.013
After treatment
ATIII	DAS28	–0.686	0.002
ATIII	CRP	–0.598	0.009
ATIII	ESR	–0.607	0.008
APTT	ESR	0.485	0.041
Fibrinogen	ESR	0.483	0.042

Demographic and clinical characteristics of GR and MR to baricitinib treatment

Characteristic	GR, (n = 8)	MR (n = 10)	Difference, p-value
Demographics
Sex (female), n (%)	7 (87.5)	10 (100)	ns
Age (years), mean (±SD)	50 (±12.9)	53.3 (±13.4)	ns
BMI (kg/m²), mean (±SD)	25 (±3.6)	24.6 (±4.2)	ns
CV risk factors
Smoking^a, n (%)	1 (12.5)	3 (27.3)	ns
Dyslipidemia^b, n (%)	6 (75)	7 (63.6)	ns
Arterial hypertension, n (%)	2 (25)	3 (27.3)	ns
Diabetes mellitus, n (%)	1 (12.5)	0 (0)	ns
Hormonal contraception	0 (0)	1 (9.1)	ns
RA status
Disease duration (years), mean (±SD)	8.3 (±7.4)	9.5 (±9.3)	ns
RF (IU/mL), mean (±SD)	107.5 (±113)	248.2 (±231.6)	ns
ACPA (U/mL), mean (±SD)	473.2 (±59.8)	404.8 (±184.1)	ns
RA treatment
Previous biologic therapy, n (%)	2 (25)	1 (9.1)	ns
GCs, n (%)	3 (37.5)	8 (72.7)	ns
dose (mg^c), mean (±SD)	5 (2.5)	4.7 (±1.6)	ns
cDMARDs, n (%)	6 (75)	8 (72.7)	ns
Methotrexate, n (%)	5 (62.5)	8 (72.7)	ns
Sulfasalazine, n (%)	2 (25)	3 (27.3)	ns
Hydroxychloroquine, n (%)	3 (37.5)	2 (18.2)	ns
Disease activity
DAS28-ESR, mean (±SD)	5.5 (±0.6)	6.1 (±1.1)	ns
VAS pain (mm), mean (±SD)	78.1 (14.2)	74.1 (±8.8)	ns
Joints (painful), mean (±SD)	13 (±5.2)	13.1 (±7)	ns
Joints (tender), mean (±SD)	7 (±3.6)	7.5 (±7.1)	ns
CRP (mg/L), mean (±SD)	12.5 (18.4)	31.2 (±39.2)	ns
ESR (mm/h), mean (±SD)	18.1 (±18.9)	33 (±25.9)	ns

Demographic and clinical characteristics between RA patients and HC

Characteristic	RA patients, (n = 18)	HC (n = 20)	Difference, p-value
Demographics
Sex (female), n (%)	17 (94.4)	12 (60)	p = 0.02
Age (years), mean (±SD)	51.9 (±3.0)	44.0 (±3.2)	ns
BMI (kg/m²), mean (±SD)	24.8 (±3.8)	25.9 (±3.5)	ns
CV risk factors
Smoking^a, n (%)	4 (22.2)	3 (15)	ns
Dyslipidemia^b, n (%)	13 (72.2)	6 (30)	p = 0.02
Arterial hypertension, n (%)	5 (27.8)	5 (25)	ns
Diabetes mellitus, n (%)	1 (5.6)	0 (0)	ns
Hormonal contraception, n (%)	1 (5.6)	1 (5)	ns
RA status
Disease duration (years), mean (±SD)	10.14 (±1.5)
ACPA (U/mL), mean (±SD)	312.6 (±55.0)
RF (IU/mL), mean (±SD)	160.2 (±46.3)
RA treatment
Previous biologic therapy, n (%)	3 (16.7)
GCs, n (%) dose (mg^c), mean (±SD)	11 (61.1) 3.1 ± 0.6
cDMARDs, n (%)	14 (77.8)
Methotrexate, n (%)	13 (72.2)
Sulfasalazine, n (%)	5 (27.8)
Hydroxychloroquine, n (%)	5 (27.8)
Disease activity
DAS28-ESR, mean (±SD)	5.8 ± 0.2
VAS pain (mm), mean (±SD)	75.9 ± 2.7
Joints (painful), mean (±SD)	13.1 ± 1.4
Joints (tender), mean (±SD)	7.3 ± 1.3
CRP (mg/L), mean (±SD)	22.9 ± 7.6
ESR (mm/h), mean (±SD)	26.4 ± 5.6

Thrombotic Markers in Plasma as Predictors of Response in Rheumatoid Arthritis Patients Treated with Baricitinib – Pilot Observation

Figures & Tables

Fig 1.

Fig 2.

Fig 3.

Clinical characteristics of patients with RA treated with baricitinib: GR and MR

Correlation between the chosen parameters of thrombosis and clinical data

Demographic and clinical characteristics of GR and MR to baricitinib treatment

Demographic and clinical characteristics between RA patients and HC

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