Publications

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.

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.

Hernández-Hernández et al. showed that in a real-world clinical settings, UPA persistence is lower among RA patients who have received prior IL-6i treatment; and that treatment strategies to avoid UPA in patients with cardiovascular risk (CVR) appear to be primarily driven by pivotal safety studies rather than regulatory guidance.

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.

Wieczorek et al. present the first evidence supporting the use of a dual JAK and ROCK inhibitor as a potential treatment option for patients with RA who have inadequate response to MTX. Wieczorek et al. conducted a randomised, Phase 2 study of CPL’116 in patients with RA with inadequate response to MTX, to evaluate dose-dependent effects on disease control and pharmacokinetics, and its effect on laboratory abnormalities among other safety assessments.

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.

Di Napoli et al. conducted a global pharmacovigilance analysis comparing MACE between JAKis and anti-TNFα therapies in patients with RA. JAKis were more frequently associated with reported MACE, particularly stroke, and had a shorter median time to onset than
anti-TNFα therapy.

Kanda et al. investigated the efficacy of second-line b/tsDMARDs in RA patients unresponsive to first-line b/tsDMARDs. Using data from the FIRST registry, the study assessed 687 patients with RA treated with TNFis, IL-6 receptor inhibitors, cytotoxic T-lymphocyte-associated protein 4 immunoglobulin, or JAKis. After propensity score-based adjustment, JAKi showed the highest persistence rate, greatest improvement in CDAI, and highest remission rates at 24 weeks. Among JAKi, UPA was most effective in achieving remission, with a safety profile comparable to other b/tsDMARDs.

Eberhard et al. investigated the effectiveness of JAKi versus bDMARDs on pain reduction in RA patients, using Swedish national register data. JAKi treatment resulted in a significantly greater reduction in pain at three months compared with TNFis, with a higher proportion achieving low pain at 12 months, particularly in those previously treated with multiple bDMARDs.

Zhao et al. found that among patients with PsA or axSpA, JAKi were not associated with increased risk of CVD or common cancers compared to TNFi or IL-17i.