JAK Inhibitors and the Risk of Malignancy: A Meta-analysis Across Disease Indications

Ann Rheum Dis. 2023;82(8):1059–1067 doi: 10.1136/ard-2023-224049

The objective of this study was to estimate the association of JAKi with the incidence of malignancy, compared with placebo, TNFi and MTX.

The results from Simon, et al. show that baricitinib treatment correlates with improvements in bone stiffness. Further improvements were also observed at the end of Week 52, with an increase in estimated failure load and no measurable progression in bone erosion being reported.

Reinisch, et al. show that filgotinib treatment has no effect on semen parameters for men with active inflammatory diseases. This contrasts with pre-clinical studies that showed fertility issues in male animals.

Pots hoc analysis of peficitinib Phase 3 trials shows that continued treatment with peficitinib up to Week 52 is linked to improved remission rates in Asian patients with RA.

Pots hoc analysis of safety data in patients with RA at increased risk of CV events from the upadacitinib SELECT phase III RA clinical programme helps to contextualise the overall risk profile of upadacitinib.

An increased incidence of liver diseases emphasizes greater caution in prescribing antirheumatic drugs, owing to their hepatotoxicity. However, drug-induced liver injury (DILI) in RA patients represents an aetiological and therapeutic challenge, due to the intertwining of inflammatory and metabolic elements mediated by IL-6 and TNF-α.

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Observational, nationwide cohort study finds no increased risk for cancer overall in RA patients treated with TNFis, anti-CD20 or anti-IL6.

Real-world population-based study shows that a switch to a second JAKinib results in a higher drug retention, as compared to switching to a TNFi, in patients with RA who discontinue original JAKinib therapy.

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May 2022

Two Phase 3 Trials of Baricitinib for Alopecia Areata

N Engl J Med. 2022. Epub ahead of print doi: 10.1056/NEJMoa2110343

Phase 3 trials in patients with severe alopecia areata show that baricitinib is superior to placebo with respect to hair regrowth at 36 weeks.
Alopecia areata is characterised by nonscarring hair loss that can affect any hair-bearing site. Although mild cases of this emotionally- and psychosocially-distressing autoimmune disease may resolve within 12 months, more severe forms of the disease are unlikely to remit without treatment.

April 2022

A Retrospective Study of the Efficacy of JAK Inhibitors or Abatacept on Rheumatoid Arthritis-Interstitial Lung Disease

Inflammopharmacology. 2022. Epub ahead of print doi: 10.1007/s10787-022-00936-w

This study of the effectiveness of JAKinibs or abatacept in patients with RA-interstitial lung disease (RA-ILD) shows that treatment is related to stability or improvement of RA-ILD in over 80% of patients.