August 2023

The 2023 Pipeline of Disease-Modifying Antirheumatic Drugs (DMARDs) in Clinical Development for Spondyloarthritis (including psoriatic arthritis): a Systematic Review of Trials

RMD Open. 2023;9(3):e003279 doi 10.1136/rmdopen-2023-003279 https://pubmed.ncbi.nlm.nih.gov/37507210/

This systematic review identified DMARDs evaluated for axSpA and PsA, distinguishing between csDMARDs, tsDMARDs, and bDMARDs. The review pinpointed twenty-six distinct targeted therapies currently in clinical development; 18 therapies for axSpA and 15 therapies for PsA.

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Do Fatty Lesions Explain the Effect of Inflammation on New Syndesmophytes in Patients with Radiographic Axial Spondyloarthritis? Results From the SIAS Cohort and ASSERT Trial

RMD Open. 2023 9(3):e003118 doi: 10.1136/rmdopen-2023-003118

This study concluded that, in r-axSpA, vertebral corner inflammation may lead to syndesmophyte formation but in a minority of cases via visible fat deposition. Here, investigators aimed to determine how much of the effect of vertebral corner inflammation on the development of syndesmophytes is explained by vertebral corner fat deposition.

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Relationship Between Paraoxonase-1 Genotype and Activity, and Major Adverse Cardiovascular Events and Malignancies in Patients with Rheumatoid Arthritis Receiving Tofacitinib

J Rheumatol. 2023 doi 10.3899/jrheum.2023-0112 Epub ahead of print

High paraoxonase activity is associated with a significantly reduced risk of MACE and non-NMSC malignancies in white/European RA patients. The PON1 Q192R RR genotype had a significantly greater association with paraoxonase versus the QQ genotype, but had no significant association with MACE or non-NMSC malignancies.

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Filgotinib Modulates Inflammation-Associated Peripheral Blood Protein Biomarkers in Adults with Active Rheumatoid Arthritis and Prior Inadequate Response to Methotrexate

Rheumatol Ther. 2023;10(5):1335–1348 doi 10.1007/s40744-023-00583-9

This study by Tanaka, et al. shows that filgotinib reduces peripheral protein biomarkers associated with JAK/STAT signalling, inflammatory signalling, immune cell migration, and bone resorption in RA patients. Notably, filgotinib 200 mg significantly reduced IL-6, TNF, CXCL13 levels as early as Week 4.

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A JAK Inhibitor for Treatment of Rheumatoid Arthritis: The Baricitinib Experience

J. Clin. Med. 2023;12(13):4527 doi 10.3390/jcm12134527

This review by Taylor, et al. reviews the long-term safety and efficacy data for baricitinib. Results from several studies showed that baricitinib has greater efficacy and survival compared to TNF inhibitors, and that the rate of CDAI <10 for baricitinib-treated RA patients increased over the course of seven years. Data also showed that remission rates were higher in real-world evidence than in RCTs.

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July 2023

Effect of Upadacitinib on Disease Activity, Pain, Fatigue, Function, Health-Related Quality of Life and Work Productivity for Biologic Refractory Ankylosing Spondylitis

Rheumatol Ther 2023; 10:679–91 doi 10.1007/s40744-023-00536-2

Upadacitinib significantly improved patient-reported outcomes in AxSpA patients with bDMARD-IR after 14 Weeks of treatment. There were notable improvements in disease activity, pain, fatigue, function, HRQoL, and work productivity.

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Effect of Intravenous Golimumab on Fatigue and the Relationship with Clinical Response in Adults with Active Ankylosing Spondylitis in the Phase 3 GO-ALIVE Study

Rheumatol Ther. 2023;10(4):983–999 doi 10.1007/s40744-023-00556-y

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.

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Tofacitinib Reduces Spinal Inflammation in Vertebral Bodies and Posterolateral Elements in Ankylosing Spondylitis: Results from a Phase 2 Trial

Rheumatol Ther. 2023;10(4):1001–1020 doi 10.1007/s40744-023-00564-y

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.

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Pain and Inflammation as Mediators of Tofacitinib Treatment Effect on Fatigue in Patients with Ankylosing Spondylitis: A Mediation Analysis

Rheumatol Ther 2023;10(4):1073–1087 doi 10.1007/s40744-023-00570-0

Kristensen, et al. used mediation modelling to show that tofacitinib indirectly improved fatigue symptoms via back pain and morning stiffness. This study was carried out using FACIT-F- and BASDAI Q1-based models to determine the relationship between these variables.

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Improvement in Patient-reported Outcomes and Work Productivity Following 3-year Ustekinumab or Tumour Necrosis Factor Inhibitor Treatment in Patients with Psoriatic Arthritis: Results from the PsABio Real-world Study

Arthritis Res Ther. 2023 Jun 23;25(1):109. doi: 10.1186/s13075-023-03058-y

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.

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