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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Tratamento da artrite reumatoide com fármacos antirreumáticos modificadores da doença convencionais, dirigidos e biológicos no contexto de lesão hepatica e de esteotose hepatica não alcoólica

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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Impact of filgotinib on sacroiliac joint magnetic resonance imaging structural lesions at 12 weeks in patients with active ankylosing spondylitis (TORTUGA trial)

Rheumatology 2022;61:2063–71 doi:10.1093/rheumatology/keab543

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.

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Effects of anti-TNF-therapy on inflammatory, structural and osteoblastic activity lesions in radiographic axial spondyloarthritis - a prospective proof-of-concept study using PET/MRI of SIJ and spine

Arthritis Rheumatol. 2022 doi: 10.1002/art.42149

Bruckmann et al carried out this observational, proof of concept study to analyse the effect anti-TNF-therapy (TNFi) on inflammatory, structural, and osteoblastic activity lesions in radiographic axial spondyloarthritis (r-axSpA).  

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March 2022

Baricitinib melhora ainda mais os efeitos de modificação da doença através do desacoplamento da associação entre atividade da doença e progressão do dano estrutural em pacientes com artrite reumatoide

Ann Rheum Dis. 2022. Epub ahead of print doi: 10.1136/annrheumdis-2021-221323

Baricitinib reduces structural damage progression versus placebo with background MTX and/or MTX, even in patients with moderate or high disease activity.In patients with RA, TNFi, IL-6i and rituximab have been shown to uncouple the link between disease activity and radiographic progression such that patients are protected from structural damage progression even if remission/low disease activity is not achieved.As such, Lopez-Romero, et al. aimed to evaluate if baricitinib further enhances diseas...

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February 2022

Terapias alvo e Janus quinases em reumatologia: um enfoque baseado nos mecanismos

Nat Rev Rheumatol. 2022 Jan 5:1–13. Epub ahead of print doi: 10.1038/s41584-021-00726-8

The development of targeted small-molecule therapies such as JAK inhibitors, which have varied selective inhibitory profiles, has enabled a paradigm shift in the treatment of diverse disorders, to the extent that they could ultimately enable either complete withdrawal or avoidance of glucocorticoid use in some autoimmune diseases, and could have the potential to regulate any active factor inhibiting the transition to cure.In this review paper, Tanaka, et al. describe the progress in JAK-targetin...

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Efeito dos ajustes de dose na eficácia e segurança de tofacitinib em pacientes com artrite reumatoide: uma análise post hoc de um estudo aberto de extensão a longo prazo (ORAL Sequel)

Clin Rheumatol. 2022 Jan 1. Epub ahead of print doi: 10.1007/s10067-021-05908-z

Post-hoc analysis shows that dosing up from tofacitinib 5 to 10 mg BID is associated with improved efficacy for up to 12 months, versus staying on 5 mg BID, and dosing down from 10 to 5 mg BID is not generally associated with a significant loss of efficacy.Although clinical trials have generally shown no significant differences, in terms of efficacy and safety, when switching tofacitinib dose up or down, these per-protocol switches are not directly informative for clinical decision-making in dai...

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January 2022

Redução da dor em pacientes com artrite reumatoide que usam opioides: uma análise post hoc de estudos de fase 3 de baricitinib

ACR Open Rheumatol. 2021. Epub ahead of print. doi: 10.1002/acr2.11380

This post hoc analysis shows that pain reduction was similar between opioid users and nonusers with baricitinib 2 mg and 4 mg, but not adalimumab.Use of opioids to treat RA-related pain has increased, yet long-term use has been associated with reduced efficacy and safety concerns. In addition, the misuse of opioids has resulted in a public health crisis in the United States and highlights the need for safe, effective nonaddictive alternatives for pain management. As such, Pope, et al. assessed p...

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