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.

Baraliakos, et al. present data from two Phase 3 studies, BE MOBILE 1 and BE MOBILE 2, that investigated the clinical efficacy and safety of bimekizumab in axSpA patients. They found that bimekizumab had sustained and consistent efficacy in patients with nr-axSpA and r-axSpA.

September 2023

In this post hoc analysis by Deoodhar, et al., the authors found that tofacitinib demonstrated greater efficacy than placebo in bDMARD-naïve and TNFi-IR AS patients. They also found that safety event rates for tofacitinib therapy were numerically higher in the TNFi-IR subgroup than the bDMARD-naïve subgroup.

The efficacy and safety of updacitinib in bDMARD-IR patients with AS were sustained through to one year in an open-label extension of the SELECT-AXIS 2 study.

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June 2023

This real-world study showed that sustained BASDAI <3 may be a valid and feasible target for a treat-to-target strategy in AxSpA, having function as treatment goal.

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The study demonstrated that obesity is a factor that could play a role in treatment decision-making in people living with inflammatory arthritis (IA). It appears that efficacy of TNFi is affected by patients’ weight/BMI in all forms of IA, while this is not the case for TCZ and ABA in RA, as well for IL-17 and IL-23 inhibitors in PsA.

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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.

Braun et al. studied a large cohort of patients with nr-axSpA, that demonstrated a secukinumab reduced SI joint inflammation (BME), this reduction was sustained over 104 weeks, from an overall low baseline level of spinal inflammation or structural damage.

Tofacitinib treatment is associated with a significant improvement in CANDEN MRI scores of spinal inflammation in axSpA patients. This study by Østergaard, et al. also validates the CANDEN MRI scoring system as an approach for measuring axSpA-associated inflammatory lesions.