Arthritis Rheumatol: A comparison of fenebrutinib with placebo or Adamu monoantigen to treat rheumatoid arthritis

Fenebrutinib is an oral highly selective Bruton tyrosine kinase (BTK) non-covalent inhibitorThe study was designed to assess the efficacy of fenebrutinib against active rheumatoid arthritis (RA)ra patients with poor response to methotrexate (queue 1,n-480) were randomly assigned to the fenebrutinib group (1 time per day, 1 50mg per day, 2 times a day 2 times 200mg), Adamu monoantigen 40mg or placebo group every 2 weeksRA patients who were poorly reactive with tumor necrosis factor inhibitors (queue 2, n-98) received fenebrutinib (2 times a day) or placeboMethotrexate continued to be treated in both queuesin cohort 1, the 12th week fenebrutinib 50mg per day group was similar to the American Society of Rheumatology score (ACR50) in the placebo group, while fenebrutinib 150mg 1 (28%) and 200mg 2 times a day (35%) were higher than the placebo group (p-0.017; p.0.0003)Fenebrutinib 200mg 2 times a day group is equivalent to Adamu monoantigen (36%) (p-0.81)In cohort 2, more patients in the fenebrutinib 200mg group reached ACR50 twice a day (25%) (p-0.072) compared to placebo (12%)The most common adverse events of fenebrutinib include nausea, headache, anemia and upper respiratory tract infectionsFenebrutinib has significant effects on bone marrow and B-cell biomarkers (CCL4 and rheumatism factors)Fenebrutinib and Adamu monoantigencan can cause overlap of B cells and bone marrow biomarkers as well as different changespatients with poor response to methotrexate, fenebrutinib showed efficacy comparable to Adamu monoantigen, and its safety was consistent with existing RA immunomodulating therapiesThese data support the potential efficacy of treating RA by targeting B cells and bone marrow cells through this new mechanism