August 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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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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July 2023

Effect of Upadacitinib on Disease Activity, Pain, Fatigue, Function, Health-Related Quality of Life and Work Productivity for Biologic Refractory Ankylosing Spondylitis

Rheumatol Ther 2023; 10:679–91 doi 10.1007/s40744-023-00536-2

Upadacitinib significantly improved patient-reported outcomes in AxSpA patients with bDMARD-IR after 14 Weeks of treatment. There were notable improvements in disease activity, pain, fatigue, function, HRQoL, and work productivity.

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Tofacitinib Reduces Spinal Inflammation in Vertebral Bodies and Posterolateral Elements in Ankylosing Spondylitis: Results from a Phase 2 Trial

Rheumatol Ther. 2023;10(4):1001–1020 doi 10.1007/s40744-023-00564-y

Tofacitinib treatment is associated with a significant improvement in CANDEN MRI scores of spinal inflammation in axSpA patients. This study by Østergaard, et al. also validates the CANDEN MRI scoring system as an approach for measuring axSpA-associated inflammatory lesions.

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Pain and Inflammation as Mediators of Tofacitinib Treatment Effect on Fatigue in Patients with Ankylosing Spondylitis: A Mediation Analysis

Rheumatol Ther 2023;10(4):1073–1087 doi 10.1007/s40744-023-00570-0

Kristensen, et al. used mediation modelling to show that tofacitinib indirectly improved fatigue symptoms via back pain and morning stiffness. This study was carried out using FACIT-F- and BASDAI Q1-based models to determine the relationship between these variables.

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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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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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Post Hoc Analysis of Patients with Rheumatoid Arthritis Under Clinical Remission in Two Japanese Phase 3 Trials of Peficitinib Treatment (RAJ3 and RAJ4)

Mod Rheumatol 2023;34(3):453–65 doi: 10.1093/mr/road059

Pots hoc analysis of peficitinib Phase 3 trials shows that continued treatment with peficitinib up to Week 52 is linked to improved remission rates in Asian patients with RA.

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Tofacitinib versus Methotrexate as the First-line Disease-modifying Antirheumatic Drugs in the treatment of Rheumatoid Arthritis: An Open-label Randomized Controlled Trial

Int J Rheum Dis. 2023;26(9):1729–1736 doi: 10.1111/1756-185X.14801

This single-centre study by Khan, et al. suggests that high-dose methotrexate (25 mg/week, subcutaneously) may be as efficacious as tofacitinib in patients with established RA who are DMARD naïve or have not received a therapeutic dose of DMARDs.

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Safety profile of upadacitinib in patients at risk of cardiovascular disease: integrated post hoc analysis of the SELECT phase III rheumatoid arthritis clinical programme

Ann Rheum Dis. 2023 doi: 10.1136/ard-2023-223916

Pots hoc analysis of safety data in patients with RA at increased risk of CV events from the upadacitinib SELECT phase III RA clinical programme helps to contextualise the overall risk profile of upadacitinib.

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