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.

Keywords:

July 2023

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.

June 2023

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.

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.

April 2023

Evidence from two phase 3 RCTs showed that patients with PsA and axial involvement had greater responses when treated with a once-daily oral dose of 15 mg upadacitinib versus placebo, and a similar or greater response versus adalimumab. Safety results were comparable between patients with or without axial involvement.

March 2023

Upadacitinib Induction and Maintenance Therapy for Crohn’s Disease

N Engl J Med 2023; 388:1966–1980 doi: 10.1056/NEJMoa2212728

Upadacitinib was associated with higher percentages of remission and endoscopic response regardless of previous failure of biologic therapy. This paper reports the Phase 3 efficacy and safety results of upadacitinib in patients with moderate-to-severe Crohn’s disease.

Integrated analysis of the safety profile of upadacitinib demonstrates that it was generally well-tolerated in RA, PsA, AS and AD, with no new safety risks identified, compared with previous reports.

February 2023

Herpes Zoster en Pacientes con Artritis Inflamatorias o Colitis Ulcerosa Tratados con Tofacitinib, Baricitinib o Upadacitinib: Una Revisión Sistemática de Estudios Clínicos y Estudios de Mundo Real

Overall, this evidence supports that HZ-risk is a “class” effect of JAKi, observing a higher risk compared to other non-biologic/biologic drugs . This study aimed to systematically review the incidence of HZ among RA, PsA, AS and UC patients treated with TOFA, BARI or UPA.

Overall, this evidence supports that HZ-risk is a “class” effect of JAKi, observing a higher risk compared to other non-biologic/biologic drugs . This study aimed to systematically review the incidence of HZ among RA, PsA, AS and UC patients treated with TOFA, BARI or UPA.

November 2022

Non-pharmacological interventions are important for any rheumatic disease, but especially axSpA, where they represent the cornerstone of treatment. The aim of this study was to produce a systematic literature review on efficacy and safety of non-pharmacological and non-biological pharmacological treatments was performed.

Keywords: