体軸型脊椎関節炎 ASAS-EULAR 推奨 2022 アップデート

Ann Rheum Dis 2022; online ahead of print doi:10.1136/ard-2022-223296

Since the last update in 2016, more data have become available on existing treatment options for axSpA, and particularly on IL-17i. The increasing availability of more drugs and with different modes of action raises questions around their positioning in the treatment pathway. This review sought to update the 2016 recommendations with newly available evidence.

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Non-pharmacological interventions are important for any rheumatic disease, but especially axSpA, where they represent the cornerstone of treatment. The aim of this study was to produce a systematic literature review on efficacy and safety of non-pharmacological and non-biological pharmacological treatments was performed.

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Post hoc analysis from the FINCH 1 study highlights filgotinib as a potential beneficial treatment option for patients with RA who have had inadequate response to MTX and have high risk of disease progression and poor prognosis.

October 2022

The present analysis demonstrated that patients continuously treated with IXE were less likely to experience flare compared with patients receiving placebo. The aim of this study was to evaluate the recapture of response with open-label IXE retreatment at week 104 in patients with axSpA who flared after withdrawal of IXE therapy.

June 2022

Maksymowych et al., assessed the effects of filgotinib on inflammatory and structural changes at various spinal locations, based on MRI measures in patients with active ankylosing spondylitis in the TORTUGA trial. Correlations between changes in the inflammation score and clinical outcomes were also evaluated.

Maksymowych et al., carried out a post-hoc analysis to assess the effect of filgotinib on MRI measures of structural change in the SI joint in patients with active AS in the TORTUGA trial. This study evaluated lesions using SPARCC SSS definitions for erosion, backfill, fat metaplasia and ankylosis by two independent scoring readers.

May 2021

Long-term evaluation of tofacitinib has found limited progression of structural damage in patients with RA treated with tofacitinib for up to 5 years. Similar results were also observed for patients receiving tofacitinib monotherapy or combination therapy for up to 3 years.It is well known that inflammation in RA leads to structural damage over time, and therapies such as DMARDS have the ability to reduce inflammation whilst inhibiting the progression of structural damage. In this study, van der...

February 2021

Filgotinib doses in combination with MTX have shown improved signs, symptoms and physical function in patients with RA and limited or no prior MTX exposure. FIL 200mg monotherapy did not have a superior ACR20 response rate versus MTX. This 52-week, phase 3 study evaluated FIL in 1252 patients with RA. Patients were randomised to FIL 200mg + MTX or FIL 100mg + MTX, FIL 200 mg monotherapy, or MTX monotherapy. The primary endpoint was the proportion patients achieving ACR20 at week 24. Safety was e...
Filgotinib improved RA signs and symptoms, physical function, and inhibited radiographic progression. FIL 200mg plus MTX, but not FIL 100mg plus MTX showed non-inferiority to ADA plus MTX, based on DAS28(CRP) low disease activity. FIL was also well tolerated in RA patients with inadequate response to MTX.This 52-week, phase 3 randomised clinical trial (FINCH 1) evaluated the efficacy and safety of FIL in patients with RA randomised to FIL 200 or 100mg, ADA 40mg, or placebo, all with background M...

July 2020

This SLR informed the 2019 EULAR taskforce updating recommendations for RA management. Overall, no new safety signals were reported. The known safety profile of bDMARDs was confirmed and extended to tsDMARDS. IL-6i associated lower intestinal perforation has been further confirmed, while VTE and PE concerns in JAKi treatment need further evaluation.Previous updates for the EULAR recommendations on RA pharmacological management were conducted in 2016. In this SLR safety of csDMARDs, tsDMARDs, and...

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