Herpes zoster in Patients with Inflammatory Arthritides or Ulcerative Colitis Treated with Tofacitinib, Baricitinib or Upadacitinib: A Systematic Review of Clinical Trials and Real-world Studies

Overall, this evidence supports that HZ-risk is a “class” effect of JAKi, observing a higher risk compared to other non-biologic/biologic drugs . This study aimed to systematically review the incidence of HZ among RA, PsA, AS and UC patients treated with TOFA, BARI or UPA.

Overall, this evidence supports that HZ-risk is a “class” effect of JAKi, observing a higher risk compared to other non-biologic/biologic drugs . This study aimed to systematically review the incidence of HZ among RA, PsA, AS and UC patients treated with TOFA, BARI or UPA.

January 2023

This post-hoc analysis of 31 clinical trials in ulcerative colitis, rheumatoid arthritis and psoriatic arthritis concludes that combined influenza adverse event incidence rates were highest in ulcerative colitis, while in each indication they were generally similar across tofacitinib, placebo, and comparator groups.

December 2022

Salinas, et al. evaluate baricitinib safety with respect to VTE, MACE, and serious infection relative to TNFi in patients with RA, in routine care and observe an increased risk of VTE in patients taking baricitinib, compared to TNFi.

November 2022

In this investigation it was concluded that other biologics and apremilast were associated with a 1.4- to 3-times higher risk of hospitalisation for serious infections in PsO/PsA patients when compared to ustekinumab. These findings should be considered in the safety profile of these therapies when selecting appropriate treatment regimens in patients with PsO/PsA.

This is the largest meta-analysis to date, assessing the risk of OIs (Opportunistic infection) in patients with PsA. In coming to this conclusion, a systematic review and meta-analysis was undertaken to estimate the incidence of OIs following treatment with b- and tsDMARDs.

September 2022

Post hoc analysis, using the final dataset from ORAL Surveillance, reveals a higher risk of non-serious infections and herpes zoster with tofacitinib vs TNFi, and higher risk of serious infection events with tofacitinib 10 mg BID versus TNFi, particularly in patients aged ≥65 years.

August 2022

Herpes zoster (HZ) risk is significantly increased in seropositive RA patients with a history of HZ after the initiation of bDMARDs or tsDMARD. It is now well known that the incidence and recurrence of HZ are quite common in patients with RA in real-world clinical settings, yet there is limited evidence regarding bDMARD-dependent HZ risk among patients with a history of HZ prior to bDMARD use.

July 2022

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.

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.