Publications

東アジアの中等症から重症の活動性関節リウマチ患者にお けるBaricitinibの安全性: 臨床試験からの統合解析

Int J Rheum Dis . 2020 Jan;23(1):65-73. doi: 10.1111/1756-185X.13748.

Chen YC,

Yoo DH,

Lee CK

Post-hoc analyses of five completed phase II and III trials and an ongoing LTE suggested that BARI QD is well tolerated in East Asian patients with moderate-to-severe RA, with a similar safety and tolerability profile to the overall population.The majority of clinical evidence for RA treatments has been obtained from a predominantly Caucasian population, which may not be relevant to East Asian patients. In this post-hoc safety analysis, 740 Japanese, Taiwanese, Korean and Chinese patients were i...

Keywords:

• JAK,
• Baricitinib,
• Safety,
• Meta analysis

フェーズ2と3試験におけるウパダシチニブの曝露と反応性に 関する有効性安全性解析 関節リウマチにおけるベネフィットリスク

Clin Pharmacol Ther . 2020 Apr;107(4):994-1003. doi: 10.1002/cpt.1671.

Nader A,

Mohamed M-EF,

Winzenborg I,

Doelger E,

Noertersheuser P,

Pangan AL,

Othman AA

UPA 15 mg provided the optimal benefit-risk in RA through maximizing efficacy with only small incremental benefit with 30 mg, and with consistency across RA subpopulations and with UPA monotherapy or combination with csDMARDs. Exposure-response analyses were conducted using combined data from two Phase 2b and five Phase 3 studies in order to characterise the relationship between plasma exposure and efficacy, as well as to select safety parameters using the totality of the data in subjects with R...

Keywords:

• JAK,
• Upadacitinib,
• Efficacy,
• Safety

活動性関節リウマチ患者におけるPeficitinib 25, 50, 100, 150 mgの 有効性と安全性の比較: ランダム化対照試験のBayesian Network Meta-Analysis

Clin Drug Investig .2020 Jan;40(1):65-72. doi: 10.1007/s40261-019-00863-9.

Lee YH,

Song GG

PEF 50, 100, and 150 mg once daily was effective in treating active RA, without causing a significant risk for AEs.Intracellular pathways, including JAK and Tyk-2, are critical for immune cell activation, pro-inflammatory cytokine production, and cytokine signaling. PEF has been developed for use in RA, but the comparative efficacy and safety of regimens and dosages has not been established. A Bayesian network meta-analysis was conducted to combine direct and indirect evidence to assess the rela...

Keywords:

• JAK,
• Peficitinib,
• Meta analysis

関節リウマチにおける低分子JAK阻害薬の感染リスクに関す るシステマティックレビューとメタ解析

Rheumatology (Oxford) 2019;58(10):1755–66

Bechman K,

Subesinghe S,

Norton S,

Atzeni F,

Galli M,

Cope AP,

Winthrop KL,

Galloway JB

Absolute serious infection rates were low. However, across the JAKinibs, the incidence of HZ is higher than expected for the population. While the risk was numerically greatest with BARI, indirect comparisons between the drugs did not demonstrate any significant difference in risk. How JAKinibs increase the risk of HZ reactivation is unclear, but how different JAKs interact in the immune response suggest that there may be differences in safety profiles between JAKinib drugs, underpinned by their...

Keywords:

• Safety,
• Review

Tofacitinib は, vitroの系で 関節リウマチ患者のリンパ球で, VZV 特異的 CD4+ T Cellの免疫反応を修飾する

Rheumatology (Oxford) 2019;58(11):2051–60

Almanzar A,

Kienle F,

Schmalzing M,

Maas A,

Tony H-P,

Prelog M

TOF significantly modulated the Th1 response to Varicella-zoster-virus (VZV). The poor VZV-specific cellular immune responses in patients with RA may be considered in recommendations regarding appropriate vaccination strategies for enhancing the VZV-specific Th1 response.Previous studies have shown that treatment with JAKinibs increases HZ incidence compared with conventional DMARDs. This cross-sectional in vitro study aimed to investigate the effect of TOF on the VZV-specific T cell immune resp...

Keywords:

• JAK,
• Tofacitinib,
• MOA

メソトレキセートに効果不十分の関節リウマチ患者におけるPeficitinib (ASP015K) の有効性と安全性: 日本で実施された Phase III 無作 為化二重盲検プラセボ対照臨床試験結果 (RAJ4)

Ann Rheum Dis 2019 DOI: 10.1136/annrheumdis-2019-215164

Takeuchi T,

Tanaka Y,

Tanaka S,

Kawakami A,

Iwasaki M,

Katayama K,

Rokuda M,

Izutsu H,

Ushijima S,

Kaneko Y,

Shiomi T,

Yamada E,

van der Heijde D

Peficitinib (PEF) 100 and 150 mg demonstrated robust clinical and structural efficacy in patients with RA who have an inadequate response to MTX. In Japan, two JAK inhibitors, TOF and BARI are currently available for RA patients with an inadequate response to conventional therapies. This randomized phase 3 study (RAJ4), assessed the efficacy and safety of two PEF doses in combination with MTX compared to PBO, in Japanese MTX-IR. Patients were randomized 1:1:1 to PBO, PEF 100 mg and 150 mg with M...

Keywords:

• JAK,
• Peficitinib,
• Phase 3

抗リウマチ薬に抵抗性の中等度から重度関節リウマチ患者に おける臨床的反応性に対する Filgotinib の Placebo対照とした 効果 : FINCH 2 無作為化試験

JAMA 2019 322(4):315-325

Genovese MC,

Kalunian K,

Gottenberg JE,

Mozaffarian N,

Bartok B,

Matzkies F,

Gao J,

Guo Y,

Tasset C,

Sundy JS,

de Vlam K,

Walker D,

Takeuchi T

Among RA patients with an inadequate response or intolerance to bDMARDs, filgotinib (FIL) doses, compared to PBO resulted in significantly greater proportions achieving a clinical response at Wk12.Patients with active RA despite treatment with bDMARD therapy need treatment options. The FINCH 2 Phase 3 study compared the effects of FIL vs PBO for the treatment of RA patients with inadequate response or intolerance to ≥1 prior bDMARDs. Patients were randomized in a 1:1:1 ratio, receiving FIL 200 m...

Keywords:

• JAK,
• Filgotinib,
• Phase 3

メトトレキサートに効果不十分な関節リウマチ患者における Upadacitinib 対 Placebo または Adalimumab : フェーズ3, 二 重盲検, 無作為化対照試験結果

Arthritis Rheumatol 2019 DOI: 10.1002/art.41032

Fleischmann R,

Pangan AL,

Song IH,

Mysler E,

Bessette L,

Peterfy C,

Durez P,

Ostor AJ,

Li Y,

Zhou Y,

Othman AA,

Genovese MC

UPA demonstrated superiority to ADA in terms of clinical, functional and patient-reported outcomes with comparable radiographic inhibition. As many RA patients fail to achieve LDA and remission with TNF inhibitors and MTX there is a requirement for additional treatment options. In this SELECT-COMPARE study the clinical and functional outcomes of UPA were compared to ADA in MTX-IR patients. 1629 MTX-IR were randomly assigned 2:2:1 to; UPA 15mg QD, ADA 40mg Q2W or PBO, with background MTX. Key end...

Keywords:

• JAK,
• Upadacitinib,
• Phase 3

メトトレキサート併用または非併用トファシチニブ，またはメトトレキサート併用アダリムマブ治療中の関節リウマチ患者における帯状疱疹生ワクチン

Arthritis Care and Research 2019 DOI: 10.1002/acr.24010

Calabrese LH,

Abud-Mendoza C,

Lindsey SM,

Lee SH,

Tatulych S,

Takiya L,

Iikuni N,

Soma K,

Luo Z,

Fleischmann R

Live zoster vaccine (LZV) was well tolerated, and herpes zoster (HZ) incidence rates were generally similar between treatment groups in vaccinated versus non-vaccinated patients in a subset of RA who received LZV before TOF ± MTX, or ADA + MTX, in ORAL Strategy. It is known that patient with RA are at increased risk of developing HZ though the mechanisms behind this are currently not well understood though therapies, such as TOF, are thought to increase the risk. ACR and EULAR recommend using LZ...

Keywords:

• JAK,
• Tofacitinib,
• Vaccination

メトトレキサートで効果不十分な活動性関節リウマチに対するウパダシチニブ単剤治療 (SELECT-MONOTHERAPY): 無作為化プラセボ対照二重盲検フェーズ３試験

Lancet. 2019 Jun 8;393(10188):2303-2311

Smolen JS,

Pangan AL,

Emery P,

Rigby W,

Tanaka Y,

Vargas JI,

Zhang Y,

Damjanov N,

Friedman A,

Othman AA,

Camp HS,

Cohen S

UPA monotherapy showed statistically significant improvements in clinical and functional outcomes versus continuing MTX in MTX inadequate-responder patients with RA. Despite its proven effectiveness and safety, many patients are unable to tolerate MTX due to its side-effects. Therapies that can be used without concomitant MTX therefore, have an important place in RA management. In previous studies, UPA has shown efficacy in combination with stable background csDMARDs in RA patients who are DMARD...

Keywords:

• JAK,
• Upadacitinib,
• Phase 3