JAK Inhibitors and the Risk of Malignancy: A Meta-analysis Across Disease Indications

Ann Rheum Dis. 2023;82(8):1059–1067 doi: 10.1136/ard-2023-224049

The objective of this study was to estimate the association of JAKi with the incidence of malignancy, compared with placebo, TNFi and MTX.

May 2023

Ixekizumab, has been shown to be efficacious against paradoxical palmoplantar pustulosis which has been reported following the administration of therapeutic TNFi. Following the increased use of biologic therapies that improve patients’ quality of life are causing paradoxical adverse effects

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Secukinumab, an IL-17A monoclonal antibody, was shown to have remarkable efficacy for axSpA in the MEASURE 2 and MEASURE 3 trials. Previous studies have concluded that secukinumab was more efficacious in TNFi-naïve patients.

April 2023

Findings from a post hoc analysis of ORAL Surveillance can help guide individualised benefit/risk assessment and clinical decision-making on treatment with tofacitinib, based on identification of subpopulations ‘at risk’.

Retrospective cohort study found 15 501 PsO patients in the TriNetX database during January 2014–June 2022 that were prescribed bDMARDS, of which 6.3% developed inflammatory arthritis. 3.5% of all patients in the study specifically developed PsA.

TNF inhibitors (TNFi) are one main mode of therapy in patients with PsA who fail to respond to csDMARDs. However, they have a primary treatment failure rate of 40% and only a modest target of ≥20% ACR20 response. The objective of this study was to evaluate efficacy and safety of guselkumab, interleukin-23 inhibitor in the DISCOVER-1 study with active PsA patients by prior use of TNFi.

This study highlighted that continued treatment with Golimumab (GLM) QMT or GLM Q2MT was superior to placebo. The GO-BACK study was designed to evaluate the efficacy and safety of golimumab treatment withdrawal in adults with nr-axSpA who demonstrate inactive disease during a 10-month open label GLM run-in.

March 2023

These real-world data from PsABio on gender differences suggest that, at the start of biologic treatment, females have a worse clinical picture of PsA than males. In coming to these conclusions and others, this study sought to investigate effects of gender on disease characteristics and treatment impact in patients with PsA.

MACEs were observed in patients newly receiving compensation from the Long-term Illness Scheme for AS. The objective of this study was to describe the incidence of MACEs in French patients newly benefiting from the French LTI for AS. The study also sought to evaluate the effect of various treatments on the risk of MACE occurrence.

Results from the open-label, randomised controlled ORAL Surveillance trial find increased risk of malignancies with tofacitinib versus TNFi, highlighting the highest incidence in patients with a history of atherosclerotic cardiovascular disease or increasing cardiovascular risk.