The 2023 EULAR recommendations provided an updated consensus on the pharmacological management of PsA with a new overarching principle and recommendation for 2023. Recent MOA safety data emphasised the importance of patient-specific benefit-risk profiling in JAKi therapy, and extra-musculoskeletal (MSK) manifestations related to PsA should be considered during drug selection.

Fleischmann, et al. found that patients who switched from adalimumab to upadacitinib and vice versa following lack of improvement showed improvements in disease activity measures and functional outcomes through 228 weeks.

Risk of venous thromboembolism with tofacitinib versus tumor necrosis factor inhibitors in cardiovascular risk-enriched rheumatoid arthritis patients

Arthritis Rheumatol 2024 doi: 10.1002/art.42846 Epub ahead of print https://pubmed.ncbi.nlm.nih.gov/38481002/

This post hoc analysis of ORAL Surveillance showed that incidence of venous thromboembolism (VTE) events was higher in patients with RA treated with tofacitinib (10>5mg BID) versus TNFi. Across treatments, VTE risk factors (age, BMI, and VTE history) were aligned with previous studies in the general RA population.

This retrospective analysis by Weddell, et al. found no difference in IL-17Ai (secukinumab and ixekizumab) survival rates and no relationship between PsA or axSpA diagnosis and drug survival. They also noted lower survival figures at 2 years of treatment.

The results of the meta-analysis show that TNFi, IL-17i, and JAK inhibitor treatments significantly improved sacroiliac joint SPARCC scores in patients with axSpA or AS at Weeks 12–16. However, there were no significant differences in mean improvement between the treatment groups.

Patients in France who started secukinumab therapy further from the launch of secukinumab were more likely to receive it as a first- or second-line therapy than patients who started treatment shortly after its launch, and had a higher retention rate when used as a first line treatment.

March 2024

This study by Rech, et al. shows that 6-month treatment with abatacept was associated with a decrease in MRI inflammation, clinical symptoms, and risk of RA development in participants at high risk. The effects of the intervention persist through a 1-year drug-free observation phase.

This study by Cho, et al. did not find any significant differences in remission rates in South Korean patients with RA that were treated with tofacitinib versus TNFi in a real-world setting. Remission rates were significantly higher for patients naïve to both JAKi and bDMARDs treated with tofacitinib versus TNFi.

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This post hoc analysis of the SPIRIT-H2H study showed that patients with PsA that were treated with ixekizumab had significantly higher rates of symptom resolution versus adalimumab at Weeks 12 and 52 in distal interphalangeal joint disease and nail PsO.

Incident rates of TEAEs were comparable for patients with PsO, PsA, and axSpA and did not increase with prolonged ixekizumab (IXE) treatment. Deodhar, et al. presented the final update on the long-term safety of IXE up to 6 years in PsO patients and up to 3 years in PsA and axSpA patients. Exposure-adjusted incident rates were calculated using patient data (TEAEs, SAEs, selected AEs) from 25 clinical trials.

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