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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Mease et al. assessed the comparative effectiveness of bimekizumab and risankizumab in patients with PsA over 52 weeks using a matching-adjusted indirect comparison (MAIC). The study included patients who were biologic disease-modifying anti-rheumatic drug (bDMARD) naïve or had a prior inadequate response or intolerance to tumour necrosis factor inhibitors (TNFi-IR).

July 2024

Fleischmann et al. evaluated the long-term efficacy and safety of upadacitinib in rheumatoid arthritis patients with inadequate response or intolerance to bDMARDs over five years. The study demonstrated that upadacitinib 15 mg and 30 mg were effective in maintaining disease control, with >75% of patients achieving CDAI LDA by week 260. The safety profile remained consistent with no new issues identified.

May 2024

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.

February 2024

Effectiveness of Sequential Lines of Biologic and Targeted Small Molecule Drugs in Psoriatic Arthritis: A Systematic Review

Rheumatology (Oxford). 2024 Jan 18:keae006 doi: 10.1093/rheumatology/keae006 Epub ahead of print

The authors found that there is a reduction in effectiveness of lines of bDMARDs after first-line in PsA, with inadequate data to determine response to tsDMARDs.

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This study by Cho, et al. did not find any significant differences in remission rates in South Korean patients with RA that were treated with tofacitinib versus TNFi in a real-world setting. Remission rates were significantly higher for patients naïve to both JAKi and bDMARDs treated with tofacitinib versus TNFi.

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Efficacy and safety of JAK inhibitors in rheumatoid arthritis: update for the practising clinician

Nat Rev Rheumatol 2024;20(2):101–115 DOI: 10.1038/s41584-023-01062-9

The observed benefit:risk ratio strongly favours JAKi use in the majority of patients, and HCPs should consider and adhere to guidance on high-risk patients where applicable. Szekanecz et al summarised the safety and efficacy of approved JAKis tofacitinib, baricitinib, upadacitinib, and filgotinib to aid in clinical decision making.

January 2024

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.

This pooled analysis of four Phase 3 RCTs investigated the long-term efficacy baricitinib in patients with active RA who were MTX-IR, csDMARD-IR, or bDMARD-IR. They found that baricitinib demonstrated efficacy up to 6.5 years and was well tolerated.

Kwon, et al. found that adalimumab exposure significantly reduced risk of incident and recurrent acute anterior uveitis (AAU) versus etanercept exposure and bDMARD non-exposure. Furthermore, exposure to etanercept significantly increased risk of incident and recurrent AAU versus bDMARD non-exposure.