As part of the GBD 2021, the authors provide updated estimates for the global burden of RA. In 2020, approximately 17.6 million people worldwide had RA, with a 14.1% increase in prevalence since 1990. Mortality decreased by 23.8% from 1990 to 2020. The study forecasts an increase in cases to 31.7 million by 2050.

Data from this phase 3 RCT demonstrated that the efficacy of bimekizumab observed at 16 weeks remained consistent through to 52 weeks in the treatment of bDMARD-naïve patients with PsA. Patients who started the trial on placebo and switched to bimekizumab at week 16 showed similar improvements to those patients who were randomised to receive bimekizumab at the start of the trail. No new safety signals were identified.

In the UPJOINT open label study, the proportion of patients with PsA, and an inadequate response to csDMARDs or bDMARDs, who achieved minimal disease activity with upadacitinib was in line with the results of previous studies at 24 weeks. No new safety signals were identified.

The efficacy and safety of updacitinib in bDMARD-IR patients with AS were sustained through to one year in an open-label extension of the SELECT-AXIS 2 study.

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September 2023

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.

Differential Properties of Janus Kinase Inhibitors in the Treatment of Immune-mediated Inflammatory Diseases

Rheumatology (Oxford) 2023;63(2):298–308 doi 10.1093/rheumatology/kead448

JAKis differ in structure, which affects their inhibitory concentration for different JAKs.

This review by Taylor, et al. compares the pharmacological profiles of JAKis, including abrocitinib, baricitinib, filgotinib, peficitinib, tofacitinib, and upadacitinib.

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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This study by Bergman, et al. showed that RA patients are significantly more likely to adhere to upadacitinib within the first 12 months of prescription versus adalimumab, baricitinib, and tofacitinib. There was also a significantly lower risk of discontinuation for upadacitinib versus the other treatment prescriptions.

Comparing the alignment of European national recommendations for patients with PsA and axSpA with EULAR and ASAS-EULAR treatment recommendations found that only a minority of national treatment recommendations were completely aligned.

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