Olokizumab versus Placebo or Adalimumab in Rheumatoid Arthritis

N Engl J Med. 2022;387(8):715–726. doi: 10.1056/NEJMoa2201302

Phase 3 trial of olokizumab, a direct inhibitor of the IL-6 ligand, demonstrates superiority to placebo with respect to an ACR20 response at week 12 and noninferiority to adalimumab (all combined with methotrexate), in patients with RA.

Post hoc analysis, using the final dataset from ORAL Surveillance, reveals a higher risk of non-serious infections and herpes zoster with tofacitinib vs TNFi, and higher risk of serious infection events with tofacitinib 10 mg BID versus TNFi, particularly in patients aged ≥65 years.

Blocking the IL-6R is a major therapeutic advance for many diseases in adults and children. Updated consensus statement provides guidance to rheumatologists and other experts, as well as patients and administrators, on managing patients with the use of drugs blocking the IL-6 pathway.

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August 2022

Bimekizumab is associated with sustained, long-term efficacy in r-axSpA patinets across three years of treatment. In coming to this conclusion, investigators sought to assess the long-term safety, tolerability, and efficacy of bimekizumab in active r-axSpA.

Upadacitinib significantly improved the signs and symptoms of nr-axSpA compared with placebo at Week 14 in this investigation. Prior to this, upadacitinib had been shown to be effective in patients with AS. This study aimed to assess the efficacy and safety of upadacitinib in non-radiographic axial spondyloarthritis.

In this investigation bimekizumab was associated with a sustained ACR50 improvement. This was highlighted following the attempt to describe the long-term safety, tolerability, and efficacy of up to three years of bimekizumab treatment in PsA patients

Secukinumab improves the burden of heel enthesitis as assessed by patient and physician reported outcomes in patients with active SpA refractory to standard treatment. In coming to this conclusion, the ACHILLES trial aimed to demonstrate the efficacy of secukinumab on Achilles’ tendon enthesitis in SpA patients.

Herpes zoster (HZ) risk is significantly increased in seropositive RA patients with a history of HZ after the initiation of bDMARDs or tsDMARD. It is now well known that the incidence and recurrence of HZ are quite common in patients with RA in real-world clinical settings, yet there is limited evidence regarding bDMARD-dependent HZ risk among patients with a history of HZ prior to bDMARD use.

July 2022

Van der Heijde et al., carried out a study to show whether upadacitinib offers an effective treatment option for bDMARD-naïve and bDMARD-IR patients with active AS. Their results indicated that upadacitinib 15 mg significantly improved the signs and symptoms of active AS. The treatment was well tolerated for 14 weeks in bDMARD-IR patients, consistent with results observed in the upadacitinib AS bDMARD-naïve study.