Publications

Gollins et al. reported that within this cohort, the Psoriatic arthritis response criteria (PsARC) response to 4^th+ lines of b/tsDMARD was not significantly reduced compared with 2^nd/3^rd line in participants who had failed at least 3 b/tsDMARDs. Authors evaluated the primary clinical response to sequential lines of b/tsDMARD therapy in PsA, focusing on the effectiveness of later line treatments.

Bai et al. reported that JAKi therapy was associated with a reduced risk of incident uveitis compared with TNF inhibitors among patients with AS, PsO, or PsA. Authors conducted a large-scale, real world comparative study which evaluated the risk of incident uveitis among patients with psoriatic disease and AS treated with either TNFi or JAKi.

Lindner et al. report that their findings underscore the need for sex-specific treatment strategies and more comprehensive research into biological and sociocultural factors influencing therapy persistence and reasons for discontinuation in real-world settings. Authors investigated sex differences in treatment outcomes, persistence, discontinuation reasons, and adverse events during first-line b/tsDMARD therapy.

In this nationwide observational study, ixekuzumab was mainly used in patients with axSpA and PsA who had previously failed multiple b/tsDMARDs, including other IL-17 inhibitors. Although prior IL-17 treatment was associated with increased risk of withdrawal in both groups, the relatively high retention rates and improvements in all disease outcomes suggest ixekizumab as a viable option for challenging patients with multiple b/tsDMARD failures.

Schaefer et al. showed that treatment with JAKis (predominantly BARI and TOF) was associated with an increased HR of malignancies compared to treatment with bDMARDs in the overall study cohort, consistent with results from the ORAL surveillance trial. To better understand the complex role of JAKis in cancer development in RA patients, Schaefer et al. estimated the effects of JAKis compared to bDMARDs on the risk of malignancy (excluding NMSC) in patients with RA.

In more than 1500 patients from 13 European countries, Pons et al. demonstrated that secukinumab retention rates after four years were approximately 50% in both axSpA and PsA patients. Pons et al. aimed to assess retention rates and proportions of patients achieving remission and LDA, according to disease activity measures and patient-reported outcomes at 24 and 48 months, in axSpA and PsA patients initiating secukinumab. In this large real-world study, Pons et al., for the first time, report 48-month retention rates as well as rates of remission and LDA. Importantly, b/tsDMARD naïve patients demonstrated higher retention, remission and LDA rates than patients with prior b/tsDMARDs exposure, particularly in axSpA.  

Palsson et al. aimed to estimate the prevalence and predictors of ever achieving remission and sustained remission (SR) in PsA patients initiating b/tsDMARDs therapy in Sweden, using three different remission criteria (DAPSA28, DAS28CRP and EGA). Palsson et al. found that despite increased availability and a wider selection of b/tsDMARDs with different modes of action, a considerable proportion of PsA patients receiving such treatments never achieve remission and approximately half never achieve SR. Fewer swollen joints at baseline predicted a greater likelihood of SR according to all assessed remission definitions, while male sex predicted the likelihood of SR according to DAPSA28 and EGA.

Silvagni et al. aimed to comparatively assess the risk of cardiovascular events (CVE) in RA patients treated with JAKis or TNFis and to explore the interactions with patient profiles [including age, baseline cardio-cerebrovascular (CV) risk, and frailty, which is a state of decreased physiological reserve, assessed using a validated frailty index for Administrative Heathcare Databases (AHD)]. This AHD-based study highlighted no significantly increased risk of CVEs or MACEs for JAKis with respect to TNFis. The CV risk remains mainly driven by the patient profiles. The frailty, in parallel with baseline CV risk, emerged as an important determinant of CVEs, MACEs, and thromboembolic events (TEs). Frailty and baseline CV risk are key predictors of CVEs, MACEs, and TEs, and should be considered in both clinical assessment and trial design for RA patients on ts/b-DMARDs.

Maksymowych et al. evaluated the effect of ixekizumab and adalimumab versus placebo over 52 weeks on structural lesions in sacroiliac joints assessed by MRI in patients naive to biological DMARDs with radiographic axSpA from the COAST-V study. The authors reported a decrease in erosion and increase in backfill at Week 16 with further reductions in erosion and increases in backfill occurring at Week 52 in patients receiving ixekizumab.

Data from an international collaboration of registries show no evidence of an increase in CV events during the first 2 years of use with JAKi, compared to TNFi, in the general RA population.