Ferrante et al. conducted a phase 3 trial evaluating the efficacy and safety of mirikizumab in patients with moderately-to-severely active Crohn’s disease. The study demonstrated that mirikizumab significantly improved clinical and endoscopic outcomes compared with placebo at week 52, with a favourable safety profile and tolerable adverse events.

Poddubnyy et al. analysed five clinical trials to evaluate extra-musculoskeletal manifestations (EMMs) like uveitis, IBD, and psoriasis in patients treated with UPA. They observed low incidences across PsA, r-axSpA, and nr-axSpA. Numerically, uveitis rates were lower in
UPA-treated patients than in those receiving placebo, particularly in r-axSpA.

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McInnes et al. assessed the efficacy of guselkumab over 48 weeks in patients with psoriatic arthritis who had an inadequate response to TNF inhibitors. The results demonstrated consistent improvements in joint, skin, and patient-reported outcomes across all baseline-defined subgroups. Guselkumab showed greater efficacy compared with placebo at Week 24, with responses maintained or improved through Week 48.

Gossec et al. demonstrated that tofacitinib significantly reduced fatigue in patients with ankylosing spondylitis, with median times to clinically meaningful improvements of 8 and 12 weeks for initial and stable improvement events, respectively. These changes were observed as early as two weeks and were more pronounced compared to placebo.

Integrated safety analysis of tofacitinib from Phase 2 and 3 trials of patients with ankylosing spondylitis

Journal Reference: Adv Rheumatol. 2024 Dec 18;64:87 doi: 10.1186/s42358-024-00402-x

Deodhar et al. conducted a pooled analysis of Phase 2 and 3 RCT data to assess the safety of tofacitinib in AS. The results showed that tofacitinib 5 mg BID had a tolerable safety profile over 48 weeks, consistent with its use in other inflammatory conditions such as RA and PsA.

Barriers to CAR T-cell therapy in rheumatology

Lancet Rheumatol 2024 doi: 10.1016/S2665-9913(24)00240-6

Lungova et al. explored the potential of CAR T-cell therapy in autoimmune conditions such as SLE, myopathies, and systemic sclerosis. While clinical cases show promise, adoption is limited by high costs, narrow patient eligibility, and safety concerns, including cytokine release syndrome. Future targeted CAR T-cell approaches may enhance efficacy and safety.

Heutz et al. found that patients requiring bDMARDs rarely achieved DMARD-free remission, while 15–37% of those on non-bDMARDs reached this milestone, underscoring significant differences based on treatment type. This suggests the EULAR recommendation against DMARD cessation may be too generalised.

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December 2024

Alarfaj et al. demonstrate fenofibrate significantly improved clinical outcomes, inflammatory biomarkers, and quality of life in patients with mild-to-moderate UC when added to mesalamine therapy.

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Baraliakos et al. assessed the long-term efficacy and safety of upadacitinib in patients with active ankylosing spondylitis who were refractory to biologic therapy. At week 104, the treatment sustained improvements in disease activity and functional outcomes with low rates of radiographic progression and no new safety signals.

Buch et al. demonstrated that filgotinib sustained its efficacy in rheumatoid arthritis patients through Wk156 in the FINCH 4 long-term extension study, showing stable safety profiles. The study reported high ACR response rates and remission based on Boolean criteria, underlining filgotinib's potential for extended clinical benefits.