Impact of treatments on fatigue in axial spondyloarthritis: a systematic review and meta-analysis

Rheumatology (Oxford). 2024 Oct 10:keae549 doi 10.1093/rheumatology/keae549 Epub ahead of print

Delcourt et al. conducted a systematic review and meta-analysis revealing that both pharmacological (DMARDs) and non-pharmacological interventions reduce fatigue in axSpA patients over short and medium terms, with greater efficacy seen when combined.

Tanaka et al. observed that in Japanese patients with rheumatoid arthritis treated with tofacitinib, those with absolute lymphocyte counts (ALCs) <0.5x10³ cells/mm³ had a higher risk of serious infections and herpes zoster events compared to patients with higher ALC levels. This threshold may help identify increased infection risk in this population

October 2024

Efficacy of Janus kinase inhibitors in the treatment of psoriasiform atopic dermatitis

Clin Exp Dermatol. 2024 Sep 18;49:1232-1234 doi: 10.1093/ced/llae16

Napolitano et al. conducted a retrospective analysis on patients with moderate-to-severe psoriasiform atopic dermatitis (AD) treated with JAK inhibitors, showing significant improvements in disease severity scores (EASI, P-NRS, DLQI) by Week 4, with 95% of patients achieving EASI-75 and 86% achieving EASI-90 by Week 24.

Kristensen et al. compared 14 PsA drugs across five treatment classes, evaluating their real-world effectiveness over three months. Ixekizumab showed rapid effectiveness on joint disease activity and skin outcomes, performing better than IL-12/23i and IL-23i, and comparable to TNFi and JAKi. More patients with active psoriasis achieved minimal disease activity with Ixekizumab than other therapies.

Su et al. conducted a comprehensive systematic review and network meta-analysis to assess the efficacy and safety of therapies for difficult-to-treat (D2T) RA. They found that tocilizumab and rituximab had superior efficacy and safety profiles, with 8mg every 4 weeks of tocilizumab identified as the optimal therapeutic dose.

Kandeel et al. compared JAK inhibitors and TNF inhibitors in RA. JAK inhibitors demonstrated better functional improvement via HAQ-DI but showed insignificant difference in CDAI compared to TNF inhibitors; both classes had similar safety.

September 2024

Adami et al. conducted a retrospective analysis to evaluate the GC sparing effects of JAKi versus bDMARDs in rheumatoid arthritis patients. They found that JAKi therapy was associated with a significant reduction in GC dose compared with bDMARDs. This suggests that JAKi could be more effective in reducing long-term GC exposure in RA patients.

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August 2024

Patients classified as having a high neutrophil-to-lymphocyte ratio (NLR-High) who received filgotinib 200mg + MTX/csDMARDs exhibited consistently better responses after 12 weeks across clinical trials, clinical endpoints, and PROs, compared with NLR-Low patients. Taylor et al. analysed data from the 3 FINCH trials to investigate the potential association of baseline NLR with improved clinical response to filgotinib in MTX-naïve or MTX-experienced RA populations.

June 2024

A disease-associated gene desert directs macrophage inflammation through ETS2

Nature 2024 doi: 10.1038/s41586-024-07501-1 Epub ahead of print

Stankey, et al. used functional genomics to show that the ETS2 gene is a central regulator of human inflammatory macrophages. They also found that ETS2 was disrupted by JAK inhibitors and MEK inhibitors, with multiple MEK inhibitors being shown to downregulate ETS2-target genes.

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Goldman, et al. conducted a pharmacovigilance study to evaluate the cardiovascular safety of JAK inhibitors in RA patients. The study demonstrated an increase in the reporting of VTE, stroke, and ischemic heart disease in patients treated with JAK inhibitor compared to bDMARDs, especially within the first year of treatment. This suggests a class effect of JAK inhibitors on cardiovascular risk, emphasising the need for ongoing surveillance and proactive cardiovascular risk management.