Buch et al. demonstrated that filgotinib sustained its efficacy in rheumatoid arthritis patients through Wk156 in the FINCH 4 long-term extension study, showing stable safety profiles. The study reported high ACR response rates and remission based on Boolean criteria, underlining filgotinib's potential for extended clinical benefits.

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.

November 2024

Tanaka et al. observed that in Japanese patients with rheumatoid arthritis treated with tofacitinib, those with absolute lymphocyte counts (ALCs) <0.5x10³ cells/mm³ had a higher risk of serious infections and herpes zoster events compared to patients with higher ALC levels. This threshold may help identify increased infection risk in this population

Buch et al. evaluated the efficacy and safety of filgotinib in patients with moderately active rheumatoid arthritis and inadequate response to methotrexate in the FINCH 1 study. At     Wk 12, ACR20 response rates were significantly higher with filgotinib 200 mg (77.9%) and 100 mg (67.8%) compared to placebo (43.8%). Safety profiles for both filgotinib doses were similar to adalimumab.

October 2024

Su et al. conducted a comprehensive systematic review and network meta-analysis to assess the efficacy and safety of therapies for difficult-to-treat (D2T) RA. They found that tocilizumab and rituximab had superior efficacy and safety profiles, with 8mg every 4 weeks of tocilizumab identified as the optimal therapeutic dose.

Kandeel et al. compared JAK inhibitors and TNF inhibitors in RA. JAK inhibitors demonstrated better functional improvement via HAQ-DI but showed insignificant difference in CDAI compared to TNF inhibitors; both classes had similar safety.

September 2024

van Vollenhoven et al. compared the efficacy and safety of upadacitinib monotherapy to methotrexate monotherapy over five years in methotrexate-naïve patients with rheumatoid arthritis. The study found that upadacitinib provided better long-term efficacy and higher rates of disease activity remission than methotrexate; however, it was associated with higher incidences of adverse events, particularly at the higher dose of 30 mg.

Fleischmann et al. evaluated the long-term efficacy and safety of upadacitinib in rheumatoid arthritis patients with inadequate response or intolerance to bDMARDs over five years. The study demonstrated that upadacitinib 15 mg and 30 mg were effective in maintaining disease control, with >75% of patients achieving CDAI LDA by week 260. The safety profile remained consistent with no new issues identified.

Adami et al. conducted a retrospective analysis to evaluate the GC sparing effects of JAKi versus bDMARDs in rheumatoid arthritis patients. They found that JAKi therapy was associated with a significant reduction in GC dose compared with bDMARDs. This suggests that JAKi could be more effective in reducing long-term GC exposure in RA patients.

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August 2024

Patients classified as having a high neutrophil-to-lymphocyte ratio (NLR-High) who received filgotinib 200mg + MTX/csDMARDs exhibited consistently better responses after 12 weeks across clinical trials, clinical endpoints, and PROs, compared with NLR-Low patients. Taylor et al. analysed data from the 3 FINCH trials to investigate the potential association of baseline NLR with improved clinical response to filgotinib in MTX-naïve or MTX-experienced RA populations.