Following discontinuation of secukinumab 150mg or 300mg, a proportion of patients sustained low PASI with clear or almost clear skin despite being drug free for up to 2 years. Patients with a shorter disease duration were less likely to relapse, further supporting the hypothesis that earlier intervention with secukinumab may result in long-term control of moderate-to-severe psoriasis.

Pacheco et al. demonstrated that, compared with axSpA patients who respond to secukinumab,  patients who do not respond show increased IL-17A-producing cells and have a more pronounced type 1 IFN signature, indicating a larger inflammatory burden.

July 2024

McInnes et al. reported that bimekizumab demonstrated sustained efficacy and safety over 52 weeks in patients with psoriatic arthritis (PsA), regardless of concomitant methotrexate (MTX) use. Both bimekizumab groups (with and without MTX) showed similar improvements in achieving ACR50 and PASI100 responses.

van Vollenhoven et al. compared the efficacy and safety of upadacitinib monotherapy to methotrexate monotherapy over five years in methotrexate-naïve patients with rheumatoid arthritis. The study found that upadacitinib provided better long-term efficacy and higher rates of disease activity remission than methotrexate; however, it was associated with higher incidences of adverse events, particularly at the higher dose of 30 mg.

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.

This study by Mahadevan, et al. evaluated pregnancy outcomes in patients exposed to upadacitinib during pregnancy. Rates of adverse pregnancy outcomes with upadacitinib exposure were comparable to rates observed in the general population or patients with autoimmune inflammatory diseases not receiving upadacitinib. The data were limited for in utero exposure to upadacitinib, so definitive conclusions cannot be drawn regarding the effect of upadacitinib on pregnancy outcomes.

This post hoc analysis provides additional support for the utility of risankizumab therapy in patients with moderately to severely active CD. Investigators examined the efficacy of risankizumab for providing early symptom relief, along with the prognostic value of early symptom relief for achieving future clinical and endoscopic endpoints.

Results of this analysis by Blauvelt, et al. showed a low adjudicated suicidal ideation and behaviour (SIB) rate of 0.13/100 patient-years for bimekizumab, consistent with general psoriasis population ranges. Bimekizumab did not increase the risk of SIB compared to other anti-IL-17A/anti-IL-23 therapies.

June 2024

Subcutaneous risankizumab maintenance therapy results in durable improvement in clinical and endoscopic outcomes over one year in patients with moderately to severely active Crohn’s disease. Endpoint achievement tended to be achieved in a higher proportion of patients treated with 360mg risankizumab than 160mg risankizumab, and both doses were higher when compared to placebo.

The outcomes of children born to mothers with autoimmune rheumatic diseases

Lancet Rheumatol 2024:S2665-9913(24)00096-1 doi: 10.1016/S2665-9913(24)00096-1 Epub ahead of print

This Series paper by Andreoli, et al. provides a comprehensive overview of the literature for pregnancy outcomes for mothers with autoimmune rheumatic disease, and provides guidance on discussing these topics with patients. They also provide a list of frequently asked questions related to pregnancy and children by women with autoimmune rheumatic diseases.