July 2022

Efficacy and Safety of Upadacitinib for Active Ankylosing Spondylitis Refractory to Biological Therapy: A Double-blind, Randomised, Placebo-controlled Phase 3 Trial

Ann Rheum Dis 2022 doi:10.1136/annrheumdis-2022-222608

Van der Heijde et al., carried out a study to show whether upadacitinib offers an effective treatment option for bDMARD-naïve and bDMARD-IR patients with active AS. Their results indicated that upadacitinib 15 mg significantly improved the signs and symptoms of active AS. The treatment was well tolerated for 14 weeks in bDMARD-IR patients, consistent with results observed in the upadacitinib AS bDMARD-naïve study.

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Is the Risk of Infection Higher During Treatment with Secukinumab than with TNF-inhibitors? An Observational Study from the Nordic Countries

Rheumatology (Oxford). 2022 doi: 10.1093/rheumatology/keac358

Glintborg B et al, highlight in their recent research from the Nordic countries, that there is a low frequency of hospitalised infections during treatment with secukinumab or TNFi in patients with SpA and PsA. In clinical practice, secukinumab was found to double absolute risk of 1st year hospitalised infection compared with adalimumab, with the other TNFi treatments falling in between.

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Efficacy and safety of ixekizumab in patients with active psoriatic arthritis with and without concomitant conventional disease‑modifying antirheumatic drugs: SPIRIT‑P1 and SPIRIT‑P2 3‑year results

Clin Rheumatol. 2022 doi: 10.1007/s10067-022-06218-8

In this investigation ixekizumab showed sustained efficacy in PsA therapy for up to three years in both monotherapy and combination with MTX or a csDMARD. Here, investigators set out to evaluate the three-year efficacy and safety of ixekizumab with and without csDMARD use in patients with active PsA.

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Identification of novel off targets of baricitinib and tofacitinib by machine learning with a focus on thrombosis and viral infection

Sci Rep. 2022 doi: 10.1038/s41598-022-11879-1

Established machine learning approaches, based on ligand similarity, identified previously unknown off-target interactions of baricitinib and tofacitinib, and adds to the evidence that these JAK inhibitors are promiscuous binders, and highlight the potential for repurposing.

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Unincreased risk of hospitalized infection under targeted therapies versus methotrexate in elderly patients with rheumatoid arthritis: a retrospective cohort study

Arthritis Res Ther. 2022 doi: 10.1186/s13075-022-02807-9

Retrospective, longitudinal, population-based study shows that despite an overall higher incidence of hospitalised infection (HI) in both elderly and older elderly patients compared to young patients, the risks of HI in patients exposed to targeted therapy versus MTX is not significantly increased.

June 2022

Efficacy and Safety of Selective TYK2 Inhibitor, Deucravacitinib, in a Phase II Trial in Psoriatic Arthritis

Ann Rheum Dis. 2022 doi: 10.1136/annrheumdis-2021-221664

In this study Mease, et al. aimed to evaluate the efficacy and safety of deucravacitinib in patients with active PsA. Treatment with the selective TYK2i deucravacitinib was well tolerated and resulted in greater improvements than placebo in ACR-20 as well as Multiplicity-controlled secondary endpoints and other exploratory efficacy measures in patients.

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Persistence and Effectiveness of the IL-12/23 Pathway Inhibitor Ustekinumab or Tumour Necrosis Factor Inhibitor Treatment in Patients with Psoriatic Arthritis: 1-year Results From the Real-world PsABio Study

Ann Rheum Dis 2022 doi: 10.1136/annrheumdis-2021-221640

Many RCTs have demonstrated efficacy and safety of biologics in PsA. However, long term comparative real world data is lacking. This study aimed to evaluate the real-world effectiveness and persistence of the IL-12/23 inhibitor ustekinumab or a TNFi for PsA 1 year post initiation. As a result, they found that PS-adjusted comparisons demonstrated comparable overall persistence, effectiveness and safety for both modes of action in PsA.

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Treatment of rheumatoid arthritis with conventional, targeted and biological disease‑modifying antirheumatic drugs in the setting of liver injury and non‑alcoholic fatty liver disease

Rheumatol Int. 2022 doi: 10.1007/s00296-022-05143-y

An increased incidence of liver diseases emphasizes greater caution in prescribing antirheumatic drugs, owing to their hepatotoxicity. However, drug-induced liver injury (DILI) in RA patients represents an aetiological and therapeutic challenge, due to the intertwining of inflammatory and metabolic elements mediated by IL-6 and TNF-α.

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Short- and longer-term cancer risks with biologic and targeted synthetic disease-modifying antirheumatic drugs as used against rheumatoid arthritis in clinical practice

Rheumatology (Oxford) 2022 doi: 10.1093/rheumatology/keab570

Observational, nationwide cohort study finds no increased risk for cancer overall in RA patients treated with TNFis, anti-CD20 or anti-IL6.

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May 2022

Risk of major adverse cardiovascular events in patients initiating biologics/apremilast for psoriatic arthritis: a nationwide cohort study

doi: 10.1093/rheumatology/keab522

Pina Vegas and her colleagues sought to assess the relative risk of MACEs in patients with PsA initiating bDMARDs or apremilast. They found that overall, the data produced overall a positive picture regarding the incidence of MACE in treatment.

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