Mease et al. conducted a post-hoc analysis of the phase 3 DISCOVER-2 trial to assess the persistence of clinically relevant improvements with guselkumab in biologic-naïve patients with PsA. The analysis showed that guselkumab maintained clinical improvements in joint and skin domains at consecutive dosing visits (Q8W) and over time.

Baraliakos et al. assessed the long-term efficacy and safety of upadacitinib in patients with active ankylosing spondylitis who were refractory to biologic therapy. At week 104, the treatment sustained improvements in disease activity and functional outcomes with low rates of radiographic progression and no new safety signals.

Poddubnyy et al. analysed five clinical trials to evaluate extra-musculoskeletal manifestations (EMMs) like uveitis, IBD, and psoriasis in patients treated with UPA. They observed low incidences across PsA, r-axSpA, and nr-axSpA. Numerically, uveitis rates were lower in
UPA-treated patients than in those receiving placebo, particularly in r-axSpA.

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Barriers to CAR T-cell therapy in rheumatology

Lancet Rheumatol 2024 doi: 10.1016/S2665-9913(24)00240-6

Lungova et al. explored the potential of CAR T-cell therapy in autoimmune conditions such as SLE, myopathies, and systemic sclerosis. While clinical cases show promise, adoption is limited by high costs, narrow patient eligibility, and safety concerns, including cytokine release syndrome. Future targeted CAR T-cell approaches may enhance efficacy and safety.

Haraoui et al. conducted a subgroup analysis of the CANTORAL study, showing that tofacitinib effectiveness was similar in patients with or without CV risk enrichment. However, AEs, particularly in older patients (≥65 years), were more frequent in the CV+ cohort. These findings highlight the need for tailored CV risk management when treating RA with tofacitinib.

Baricitinib as monotherapy for treatment of rheumatoid arthritis: analysis of real-world data

Current Medical Research and Opinion 2024;40:1993–2002 doi: 10.1080/03007995.2024.2416979.

Edwards et al. report on real-world data for baricitinib monotherapy in rheumatoid arthritis, showing significant disease activity reduction across multiple registries and observational studies. These findings reinforce the viability of baricitinib monotherapy in clinical practice for RA patients, complementing existing guidelines.

Choy et al. investigated the efficacy and safety of intensified versus standard infliximab dosing for steroid-refractory acute severe ulcerative colitis (ASUC). The study found that a first dose of 10mg/kg infliximab was not superior to the standard 5mg/kg dose in achieving clinical response by Day 7. Earlier responses were noted with dose intensification, but no significant differences were observed in remission, colectomy rates, or safety profiles by Month 3.

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October 2024

Østergaard et al. conducted a phase 4 multicentre, single-arm, open-label study to evaluate the effect of apremilast on MRI-assessed inflammation in PsA patients using PsAMRIS and MRI-WIPE. The study demonstrated that apremilast reduced inflammation in joints and entheses with no structural damage progression. The study also supports the use of MRI as an objective tool in PsA trials.

Kavanaugh et al. conducted a post hoc analysis of a phase 2 trial examining deucravacitinib in patients with active psoriatic arthritis, focusing on the achievement of MDA components.

The analysis demonstrated that treatment with deucravacitinib led to a higher proportion of patients meeting each MDA component compared with placebo at 16 weeks.

Impact of treatments on fatigue in axial spondyloarthritis: a systematic review and meta-analysis

Rheumatology (Oxford). 2024 Oct 10:keae549 doi 10.1093/rheumatology/keae549 Epub ahead of print

Delcourt et al. conducted a systematic review and meta-analysis revealing that both pharmacological (DMARDs) and non-pharmacological interventions reduce fatigue in axSpA patients over short and medium terms, with greater efficacy seen when combined.