Mirikizumab as induction and maintenance therapy for ulcerative colitis

N Engl J Med 2023;388(26):2444–2455 doi: 10.1056/NEJMoa2207940

Mirikizumab was more effective than placebo in inducing and maintaining clinical remission in patients with moderately to severely active ulcerative colitis. D’Haens, et al. also noted that opportunistic infections and cancer developed in a small number of mirikizumab-treated patients.

The study demonstrated that obesity is a factor that could play a role in treatment decision-making in people living with inflammatory arthritis (IA). It appears that efficacy of TNFi is affected by patients’ weight/BMI in all forms of IA, while this is not the case for TCZ and ABA in RA, as well for IL-17 and IL-23 inhibitors in PsA.

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Braun et al. studied a large cohort of patients with nr-axSpA, that demonstrated a secukinumab reduced SI joint inflammation (BME), this reduction was sustained over 104 weeks, from an overall low baseline level of spinal inflammation or structural damage.

Results from the 3-year PsABio study demonstrated that, generally, ustekinumab and TNFi treatment led to an improvement in PROs. In coming to this conclusion, researchers aimed to evaluate the real-world effect of ustekinumab or a TNFi on PRO and their association with effectiveness endpoints in PsA patients over 3 years.

Tofacitinib treatment is associated with a significant improvement in CANDEN MRI scores of spinal inflammation in axSpA patients. This study by Østergaard, et al. also validates the CANDEN MRI scoring system as an approach for measuring axSpA-associated inflammatory lesions.

Administration of IV-golimumab 2 mg/kg improves fatigue symptoms in axial spondylitis in a 52 Week study. At Week 16 of treatment, improvements in ASAS, ASDAS, BASDAI and SF-36 scores were observed at week 16 of treatment.

Pots hoc analysis of peficitinib Phase 3 trials shows that continued treatment with peficitinib up to Week 52 is linked to improved remission rates in Asian patients with RA.

This study confirms the safety of long-term apremilast use in patients with plaque PsO, active PsA, or oral ulcers associated with Behçet’s syndrome. In coming to this conclusion, investigators conducted a pooled analysis of apremilast data from 15 clinical studies with open-label extension phases, focusing on long-term safety.

Pots hoc analysis of safety data in patients with RA at increased risk of CV events from the upadacitinib SELECT phase III RA clinical programme helps to contextualise the overall risk profile of upadacitinib.