Kristensen et al. compared 14 PsA drugs across five treatment classes, evaluating their real-world effectiveness over three months. Ixekizumab showed rapid effectiveness on joint disease activity and skin outcomes, performing better than IL-12/23i and IL-23i, and comparable to TNFi and JAKi. More patients with active psoriasis achieved minimal disease activity with Ixekizumab than other therapies.

McInnes et al. reported that bimekizumab demonstrated sustained efficacy and safety over 52 weeks in patients with psoriatic arthritis (PsA), regardless of concomitant methotrexate (MTX) use. Both bimekizumab groups (with and without MTX) showed similar improvements in achieving ACR50 and PASI100 responses.

van Vollenhoven et al. compared the efficacy and safety of upadacitinib monotherapy to methotrexate monotherapy over five years in methotrexate-naïve patients with rheumatoid arthritis. The study found that upadacitinib provided better long-term efficacy and higher rates of disease activity remission than methotrexate; however, it was associated with higher incidences of adverse events, particularly at the higher dose of 30 mg.

Fleischmann et al. evaluated the long-term efficacy and safety of upadacitinib in rheumatoid arthritis patients with inadequate response or intolerance to bDMARDs over five years. The study demonstrated that upadacitinib 15 mg and 30 mg were effective in maintaining disease control, with >75% of patients achieving CDAI LDA by week 260. The safety profile remained consistent with no new issues identified.

This study by Mahadevan, et al. evaluated pregnancy outcomes in patients exposed to upadacitinib during pregnancy. Rates of adverse pregnancy outcomes with upadacitinib exposure were comparable to rates observed in the general population or patients with autoimmune inflammatory diseases not receiving upadacitinib. The data were limited for in utero exposure to upadacitinib, so definitive conclusions cannot be drawn regarding the effect of upadacitinib on pregnancy outcomes.

Filgotinib (FIL) 200mg was associated with numerical reductions in the number of draining perianal fistulas based on combined clinical and MRI findings compared with placebo. Reinisch et al. reported a numerically higher proportion of patients achieving the primary endpoint of a combined fistula response and/or remission at Week 24 with FIL 200mg compared with placebo.

Patients classified as having a high neutrophil-to-lymphocyte ratio (NLR-High) who received filgotinib 200mg + MTX/csDMARDs exhibited consistently better responses after 12 weeks across clinical trials, clinical endpoints, and PROs, compared with NLR-Low patients. Taylor et al. analysed data from the 3 FINCH trials to investigate the potential association of baseline NLR with improved clinical response to filgotinib in MTX-naïve or MTX-experienced RA populations.

In a large pool of Phase 2b/3 trial data, the incidence rate of uveitis with bimekizumab over 2034.4 patient years (PYs) remained low at 1.2/100 PYs, suggesting bimekizumab may be an appropriate treatment option for patients with axSpA and uveitis. Compared with placebo, bimekizumab had a lower incidence rate of uveitis in patients with and without a history of uveitis.

Tofacitinib in acute severe ulcerative colitis (TACOS): A randomized controlled trial

Journal Reference: Am J Gastroenterol 2024;119:1365–72 doi: 10.14309/ajg.0000000000002635

A combination of tofacitinib and corticosteroids improved treatment responsiveness and decreased the need for rescue therapy in patients with acute severe ulcerative colitis (ASUC). Singh et al. investigated whether addition of tofacitinib to corticosteroids was superior to corticosteroids alone in patients hospitalised with ASUC.

Results of this analysis by Blauvelt, et al. showed a low adjudicated suicidal ideation and behaviour (SIB) rate of 0.13/100 patient-years for bimekizumab, consistent with general psoriasis population ranges. Bimekizumab did not increase the risk of SIB compared to other anti-IL-17A/anti-IL-23 therapies.