JAK Inhibitors and the Risk of Malignancy: A Meta-analysis Across Disease Indications

Ann Rheum Dis. 2023;82(8):1059–1067 doi: 10.1136/ard-2023-224049

The objective of this study was to estimate the association of JAKi with the incidence of malignancy, compared with placebo, TNFi and MTX.

The results from Simon, et al. show that baricitinib treatment correlates with improvements in bone stiffness. Further improvements were also observed at the end of Week 52, with an increase in estimated failure load and no measurable progression in bone erosion being reported.

Reinisch, et al. show that filgotinib treatment has no effect on semen parameters for men with active inflammatory diseases. This contrasts with pre-clinical studies that showed fertility issues in male animals.

May 2023

Ixekizumab, has been shown to be efficacious against paradoxical palmoplantar pustulosis which has been reported following the administration of therapeutic TNFi. Following the increased use of biologic therapies that improve patients’ quality of life are causing paradoxical adverse effects

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Secukinumab, an IL-17A monoclonal antibody, was shown to have remarkable efficacy for axSpA in the MEASURE 2 and MEASURE 3 trials. Previous studies have concluded that secukinumab was more efficacious in TNFi-naïve patients.

A prospective observational study showed that recombinant zoster vaccine (RZV) immunogenicity is not impaired in RA patients on JAK inhibitors or anti-cellular bDMARDs.

Investigators from a phase 2 study concluded that further investigation with BMS-986142 (a novel BTK) in people with RA is not necessary.

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Results from the 52-week phase 3 EXCEED study showed that secukinumab and adalimumab both display similar efficacy in time to resolution of enthesitis, in patients with PsA, irrespective of baseline enthesitis severity and individual site distribution.

Results from the 2-year phase 3 study FUTURE 5 show that the majority of patients with PsA who are treated with secukinumab were able to achieve sustained low disease activity or remission by week 104.

Evidence from two phase 3 RCTs showed that patients with PsA and axial involvement had greater responses when treated with a once-daily oral dose of 15 mg upadacitinib versus placebo, and a similar or greater response versus adalimumab. Safety results were comparable between patients with or without axial involvement.