Cardiovascular Safety of Janus Kinase Inhibitor Therapy in a Multi-ethnic Population

Musculoskeletal Care 2023 doi 10.1002/msc.1853 Epub ahead of print

This study by Sunmboye, et al. investigated the relationship between CV event incidence and age in a multi-ethnic population that received JAK inhibitor therapy. They concluded that JAK inhibitor therapy was generally safe in a multi-ethnic population with a large age range, but they did find a statistically significant but numerically small positive correlation between age and CV incidence

Adalimumab demonstrated superiority over placebo in reducing fatigue in RA at 12 and 52 weeks. Other interventions, which included golimumab, baricitinib, sarilumab, tocilizumab, and tofacitinib, also proved effective in reducing fatigue in patients with RA. Secukinumab also reduced fatigue by Week 52 in patients with SpA.

These recommendations from EULAR provide consensus and up-to-date guidance on fatigue management in people with I-RMDs, which includes advice regarding pharmacological and non-pharmacological interventions.

This post hoc analysis by Curtis, et al. found that current and former smokers were more likely to switch from an anti-TNF bDMARD to a different bDMARD or JAK inhibitor in comparison to non-smokers. They also found that DAS28(CRP) ≤3.2 achievement was significantly higher after filgotinib therapy regardless of smoking status in MTX-IR, bDMARD-IR, and MTX-naïve patients.

December 2023

Post hoc analysis of ORAL Surveillance data highlights that active disease in RA leads to higher risk of adverse medical events, regardless of medication used.

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This multicentre, retrospective study by Hayashi, et al. found no significant differences in efficacy and safety between tofacitinib, baricitinib, peficitinib and upadacitinib in patients with RA. Predictive factors for resistance to LDA achievement included baseline CRP and CDAI for tofacitinib and baseline glucocorticoid dose, baseline CDAI and number of previous b/tsDMARDs for baricitinib.

Rates of MACE and VTE events in patients with RA or PsA treated are consistent across 15 mg and 30 mg doses of upadacitinib, and comparable with active comparators adalimumab and MTX. Several risk factors were also identified for MACE and VTE events in patients with RA.

Rates of malignancy were similar between upadacitinib, adalimumab, and MTX. They were also consistent across RA, PsA, AS and nr-axSpA. A dose-dependent increased rate of NMSC was observed with upadacitinib in RA. For RA and PsA, being older (≥65 years) and male was associated with
an increased risk of malignancy excluding NMSC.

October 2023

As part of the GBD 2021, the authors provide updated estimates for the global burden of musculoskeletal disorders, excluding RA, osteoarthritis, low back pain, neck pain, and gout. In 2020, the total years lived with disability globally was estimated to be 42.7 million, which was a 122% increase from 1990. Over the same time period, mortality increased by 199%. The study forecasts an increase in cases by 2050 in all regions, with the exception of Central Europe.

Effects of 1-year Tofacitinib Therapy on Angiogenic Biomarkers in Rheumatoid Arthritis

Rheumatology (Oxford) 2023; 62(SI3):SI304–SI312 doi 10.1093/rheumatology/kead502

This study by Kerekes, et al. investigated the relationship between tofacitinib therapy, angiogenic biomarker levels, and vascular inflammation and function in RA patients. The authors found that tofacitinib treatment reduced the production of bFGF, PlGF and IL-6, which may inhibit synovial and aortic inflammation.

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