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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Charles-Schoeman, et al. carried out a descriptive integrated analysis on patients with RA that were treated in the SELECT programme, with up to 6.5 years of exposure. They concluded that upadacitinib 15 mg QD had an acceptable safety profile, but long-term upadacitinib treatment was associated with dose-dependent laboratory abnormalities.

Efficacy and safety of JAK inhibitors in rheumatoid arthritis: update for the practising clinician

Nat Rev Rheumatol 2024;20(2):101–115 DOI: 10.1038/s41584-023-01062-9

The observed benefit:risk ratio strongly favours JAKi use in the majority of patients, and HCPs should consider and adhere to guidance on high-risk patients where applicable. Szekanecz et al summarised the safety and efficacy of approved JAKis tofacitinib, baricitinib, upadacitinib, and filgotinib to aid in clinical decision making.

January 2024

Secukinumab efficacy regarding PROs and retention rate was comparable between axSpA and PsA patient groups when adjusted for confounders. Christiansen et al compared 6-, 12- and 24-month pain, fatigue, PGA, and HAQ PROs in axSpA and PsA patients treated with secukinumab, as well as 24-monthy retention rates in this real-world study.  

Adalimumab demonstrated superiority over placebo in reducing fatigue in RA at 12 and 52 weeks. Other interventions, which included golimumab, baricitinib, sarilumab, tocilizumab, and tofacitinib, also proved effective in reducing fatigue in patients with RA. Secukinumab also reduced fatigue by Week 52 in patients with SpA.

These recommendations from EULAR provide consensus and up-to-date guidance on fatigue management in people with I-RMDs, which includes advice regarding pharmacological and non-pharmacological interventions.

In this two-round modified RAM study by Solitano, et al., the authors found that experts preferred to assess JAK inhibitor risk on a case-by-case basis across all specialties. Uncertainty remained on several clinical scenarios regarding the appropriate use of JAK inhibitors, however they remain an important therapy option for the treatment of IMIDs  and were deemed appropriate for patients with moderate risk profiles.

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Siderius, et al. found that secukinumab was associated with low spinal radiographic progression. Furthermore, bone-related outcomes and BTMs related to collagen resorption (sCTX, PINP) remained constant during the 2-year period, whereas the BTM related to mineralisation (BALP) decreased significantly.

Nationwide study involving 14 778 new users of targeted therapies with PsA found treatment persistence to be lower for women than men for TNFi and IL17i but not for IL-12/23i, IL-23i or JAK inhibition.

This real-world study by Kim, et al. found no significant relationship between continued JAK inhibitor therapy in patients with IMIDs and the risk of subsequent recurrent HZ reactivation. They also found no significant difference in the number of days patients were treated for HZ in the JAK inhibitor continuation and discontinuation groups.