August 2023

Relative Remission and Low Disease Activity Rates of Tofacitinib, Baricitinib, Upadacitinib, and Filgotinib versus Methotrexate in Patients with Disease-Modifying Antirheumatic Drug-Naive Rheumatoid Arthritis

Pharmacology 2023;108(6):589–598 doi 10.1159/000527186

The results of a Bayesian network meta-analysis by Lee and Song showed that JAK inhibitors were more likely to achieve remission and LDA in DMARD-naive RA patients than MTX. However, there were no significant differences in remission rates nor LDA rates between the JAK inhibitors investigated.

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Cardiovascular Safety of Janus Kinase Inhibitors in Patients with Rheumatoid Arthritis: Systematic Review and Network Meta-analysis

Front Pharmacol. 2023; 8(14):1237234 doi 10.3389/fphar.2023.1237234

This meta-analysis by Wei, et al. found that JAKi therapy was not associated with a higher risk of MACE than treatment with adalimumab, abatacept, or placebo. However, a higher incidence of all-cause mortality was observed with tofacitinib treatment than with adalimumab treatment.

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Efficacy and Safety of the TYK2/JAK1 Inhibitor Brepocitinib for Active Psoriatic Arthritis: A Phase IIb Randomized Controlled Trial

Arthritis Rheumatol. 2023;75(8):1370–1380 doi: 10.1002/art.42519

Phase IIb study of brepocitinib in patients with PsA concludes that treatment with brepocitinib 30 mg and 60 mg QD, was superior to placebo at reducing signs and symptoms of PsA and was well-tolerated over 52 weeks.

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July 2023

Filgotinib Modulates Inflammation-Associated Peripheral Blood Protein Biomarkers in Adults with Active Rheumatoid Arthritis and Prior Inadequate Response to Methotrexate

Rheumatol Ther. 2023;10(5):1335–1348 doi 10.1007/s40744-023-00583-9

This study by Tanaka, et al. shows that filgotinib reduces peripheral protein biomarkers associated with JAK/STAT signalling, inflammatory signalling, immune cell migration, and bone resorption in RA patients. Notably, filgotinib 200 mg significantly reduced IL-6, TNF, CXCL13 levels as early as Week 4.

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Post-Marketing Safety Surveillance of Tofacitinib over 9 Years in Patients with Psoriatic Arthritis and Rheumatoid Arthritis

Rheumatol Ther. 2023;10(5):1255–1276 doi: 10.1007/s40744-023-00576-8

The data gathered in this post-marketing surveillance study aligned with the previously established safety profile of tofacitinib, and reports were found to have consistent safety profiles in the treatment of both patient with PsA and RA. However, the results of this study should be interpreted considering the limitations of post-marketing surveillance studies.

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Relationship Between Paraoxonase-1 Genotype and Activity, and Major Adverse Cardiovascular Events and Malignancies in Patients with Rheumatoid Arthritis Receiving Tofacitinib

J Rheumatol. 2023 doi 10.3899/jrheum.2023-0112 Epub ahead of print

High paraoxonase activity is associated with a significantly reduced risk of MACE and non-NMSC malignancies in white/European RA patients. The PON1 Q192R RR genotype had a significantly greater association with paraoxonase versus the QQ genotype, but had no significant association with MACE or non-NMSC malignancies.

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A JAK Inhibitor for Treatment of Rheumatoid Arthritis: The Baricitinib Experience

J. Clin. Med. 2023;12(13):4527 doi 10.3390/jcm12134527

This review by Taylor, et al. reviews the long-term safety and efficacy data for baricitinib. Results from several studies showed that baricitinib has greater efficacy and survival compared to TNF inhibitors, and that the rate of CDAI <10 for baricitinib-treated RA patients increased over the course of seven years. Data also showed that remission rates were higher in real-world evidence than in RCTs.

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Baricitinib in Juvenile Idiopathic Arthritis: An International, Phase 3, Randomised, Double-blind, Placebo-controlled, Withdrawal, Efficacy, and Safety Trial

Lancet. 2023;402(10401):555–570 doi 10.1016/S0140-6736(23)00921-2

Phase 3 trial of baricitinib demonstrates efficacy with acceptable safety profile in polyarticular and extended oligoarticular juvenile idiopathic arthritis, juvenile psoriatic arthritis and enthesitis-related arthritis.

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Upadacitinib in Patients with Psoriatic Arthritis and Inadequate Response to Biologics: 3-year Results from the Open-Label Extension of the Randomised Controlled Phase 3 SELECT-PsA 2 Study

Clin Exp Rheumatol. 2023;41(11):2286–2297 doi: 10.55563/clinexprheumatol/8l7bbk.

Data from this open-label extension showed the efficacy of upadacitinib observed at 56 weeks was maintained through to 152 weeks in the treatment of patients with PsA. No cumulative adverse effects were observed, and no new safety signals were identified.

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Comparative Effectiveness of First-Line Baricitinib in Patients With Rheumatoid Arthritis in the Australian OPAL Data Set

ACR Open Rheumatol. 2023;5(7):345-353 doi 10.1002/acr2.11577

Cicirello, et al. present results showing that baricitinib is comparable in treatment persistence with TNF inhibitors. However, treatment persistence up to 24 months was significantly longer for baricitinib, but the effect size of one month is not clinically meaningful.

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