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Trivalent chromium versus baricitinib for rheumatoid arthritis treatment: first phase 2/3 randomized controlled

Sally S Hassouna1, Omneya Mohamed-Ayman Abdel-Moniem2

  • 1Internal Medicine Department, Rheumatology and Clinical Immunology Unit, Faculty of Medicine, Alexandria University, Alexandria, Egypt. s_hassouna151@alexmed.edu.eg.

Inflammopharmacology
|July 19, 2024
PubMed

Insights

Trivalent chromium (Cr III) shows superior efficacy and safety compared to baricitinib in treating rheumatoid arthritis (RA), demonstrating faster clinical and sonographic improvements with fewer side effects.

Area of Science:

  • Rheumatology
  • Immunology
  • Pharmacology

Background:

  • Rheumatoid arthritis (RA) is a chronic inflammatory disease managed with disease-modifying antirheumatic drugs (DMARDs).
  • Baricitinib, an emerging DMARD, offers anti-rheumatic effects but carries significant side effects.
  • Trivalent chromium (Cr III), a natural anti-inflammatory agent, is investigated for RA treatment.

Purpose of the Study:

  • To evaluate the efficacy and safety of trivalent chromium (Cr III) in treating RA patients.
  • To compare the therapeutic effects of Cr (III) with baricitinib in RA management.
  • To assess clinical and sonographic outcomes and side effect profiles of Cr (III) versus baricitinib.

Main Methods:

  • A phase 2/3 randomized controlled trial involving RA patients.
  • Patients were randomized 2:1 to receive either Cr (III) or baricitinib.
  • Disease activity was assessed using DAS28-CRP and DAS28-ESR, ACR scores, and hand ultrasound at baseline, 3 weeks, and 12 weeks.

Main Results:

  • Cr (III) demonstrated statistically significant improvements in DAS28-CRP and DAS28-ESR compared to baricitinib (p < 0.001).
  • Higher ACR 50 and ACR 70 response rates were observed with Cr (III) versus baricitinib.
  • Significant improvements in ultrasound parameters (GLOESS, SH, PDUS, joint effusions) were noted with Cr (III), while baricitinib showed worsening in joint effusions.

Conclusions:

  • Trivalent chromium (Cr III) exhibits promising and rapid clinical and sonographic efficacy in RA patients, outperforming baricitinib in several aspects.
  • Cr (III) appears to be a potentially safer alternative with fewer side effects compared to baricitinib and other DMARDs.
  • Long-term safety data for Cr (III) in RA treatment require further investigation.
Abstract

Keywords:
ACR responseBaricitinibCDAIDAS28-CRPDAS28-ESRGLOESSHAQDIJoints effusionsLow disease activity and disease remissionPDUSRheumatoid arthritisSDAISHTrivalent chromium

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