Baricitinib could improve the prognosis of anti-MDA5 antibody positive dermatomyositis associated interstitial lung disease
Authors' conclusion
This study indicates that Baricitinib is a potential therapeutic for MDA5 + DM-ILD, reducing LDH and ferritin, ameliorating ILD progression, and improving survival, with first-line use may provide a significant survival advantage.
Study context
- Population
- Patients with anti-MDA5 antibody positive dermatomyositis (DM)-associated interstitial lung disease (ILD)
- Exposure
- Baricitinib vs no baricitinib
- Baricitinibn = 39
- Outcome
- Six-month survival
- Follow-up
- Six months
Main finding
As reported in the abstract
P = 0.047
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| Survival, first-line baricitinib vs conventional therapy (subgroup) | P = 0.046 |
- Clinical improvement after baricitinib (single group)
- 79.5% · 31 of 39
- Clinical improvement after baricitinib (single group) — Gottron's sign improved
- p < 0.001
- Clinical improvement after baricitinib (single group) — Heliotrope rash improved
- p < 0.001
- Clinical improvement after baricitinib (single group) — Dyspnea improved
- p = 0.003
- Survival, first-line baricitinib vs conventional therapy (subgroup): First-line baricitinib 84.6%
- Survival, first-line baricitinib vs conventional therapy (subgroup): Conventional therapy 52.9%
HRCT score, median, before vs after baricitinib
- Median HRCT score decreased from 115 to 97.5
- P < 0.001
FVC, before vs after baricitinib
- FVC improved, 76.44% vs 90.73%
- P < 0.001
Serum ferritin and lactate dehydrogenase (LDH), before vs after baricitinib
- Ferritin decreased, 739.9 ng/ml vs 56.3 ng/ml
- P < 0.001
- LDH decreased, 313 U/L vs 233 U/L
- P = 0.003
Lymphocyte counts, before vs after baricitinib
- CD4 + T cells increased, 354 cells/µl vs 663 cells/µl
- P < 0.001
- CD8 + T cells increased, 180 cells/µl vs 449 cells/µl
- P < 0.001
GC dose, before vs after baricitinib
- GC dose reduced from 40 mg daily to 10 mg daily
- P < 0.001
Original publication
Baricitinib could improve the prognosis of anti-MDA5 antibody positive dermatomyositis associated interstitial lung disease. Arthritis Res Ther. Published 14 November 2025. doi:10.
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