Raggiungere il controllo del dolore nell'artrite reumatoide precoce con baricitinib in monoterapia o in combinazione con metotrexato rispetto al metotrexato in monoterapia

RMD Open. 2022;8(1):e001994 doi: 10.1136/rmdopen-2021-001994

Taylor PC,

Alten R,

Álvaro Gracia JM,

Kaneko Y,

Walls C,

Quebe A,

Jia B,

Bello N,

Terres JR,

Fleischmann R

Post hoc analysis of the RA-BEGIN trial finds that, over a one-year period, patients treated with baricitinib (monotherapy or in combination with methotrexate [MTX]) report greater pain relief and a more rapid attainment of clinically meaningful thresholds of pain improvement, than patients who receive MTX monotherapy.Often overlooked, when treating RA solely to a disease activity target, patient-reported pain is common in RA, even in those reaching inflammatory remission. The fact that pain per...

Keywords:

• JAK,
• Baricitinib,
• Efficacy,
• Pain

ORAL Surveillance e sicurezza degli inibitori di JAK: la teoria della relatività

Nat Rev Rheumatol. 2022. Epub ahead of print doi: 10.1038/s41584-022-00767-7

Winthrop KL,

Cohen SB.

Putting the data into context, Winthrop, et al. conclude that the ORAL Surveillance data are not dissimilar to those from the original developmental programme, which suggested additional safety concerns at the 10 mg dosage and that resulted in the 5 mg twice daily dosage as the approved dose for RA.Following the recent results of the ORAL Surveillance (ORALSURV) study, and the consequent changes to the utilisation of JAKinibs, made by the regulatory authorities, Winthrop, et al. aim to put the O...

Keywords:

• JAK,
• Tofacitinib,
• Safety

Baricitinib migliora ulteriormente gli effetti modificanti la malattia separando l'attività di malattia e la progressione strutturale articolare nei pazienti con artrite reumatoide

Ann Rheum Dis. 2022. Epub ahead of print doi: 10.1136/annrheumdis-2021-221323

Lopez-Romero P,

de la Torre I,

Haladyj E,

Aletaha D,

Smolen JS

Baricitinib reduces structural damage progression versus placebo with background MTX and/or MTX, even in patients with moderate or high disease activity.In patients with RA, TNFi, IL-6i and rituximab have been shown to uncouple the link between disease activity and radiographic progression such that patients are protected from structural damage progression even if remission/low disease activity is not achieved.As such, Lopez-Romero, et al. aimed to evaluate if baricitinib further enhances diseas...

Keywords:

• JAK,
• Baricitinib,
• Efficacy,
• Radiographic

Sicurezza ed efficacia a lungo termine di upadacitinib o adalimumab nei pazienti con artrite reumatoide: risultati a 3 anni dallo studio SELECT-COMPARE

RMD Open. 2022;8(1):e002012 doi: 10.1136/rmdopen-2021-002012

Fleischmann R,

Mysler E,

Bessette L,

Peterfy CG,

Durez P,

Tanaka Y,

Swierkot J,

Khan N,

Bu X,

Li Y,

Song IH

Upadacitinib continues to show consistently better clinical responses, compared with adalimumab, through 3 years, including rates of remission and low disease activity, physical function and pain severity.Following the favourable upadacitinib efficacy data seen in the SELECT-COMPARE study at 72 weeks, Fleischmann, et al. assessed the long-term safety and efficacy of upadacitinib versus adalimumab over 3 years in the long-term extension of this study, with promising results. ...

Keywords:

• JAK,
• Upadacitinib,
• Safety,
• Efficacy,
• LTE

Effetto degli inibitori di JAK sulle lipoproteine ad alta e bassa densità nei pazienti con artrite reumatoide: una revisione sistematica e una meta-analisi di rete

Clin Rheumatol. 2022. Epub ahead of print doi: 10.1007/s10067-021-06003-z

Li N,

Gou ZP,

Du SQ,

Zhu XH,

Lin H,

Liang XF,

Wang YS,

Feng P.

Systematic review and network meta-analysis highlight that RA patients who receive recommended doses of the five approved JAK inhibitors (tofacitinib, baricitinib, upadacitinib, filgotinib, and peficitinib) are likely to experience an increase in serum low- and high-density lipoprotein (LDL and HDL) levels.JAK inhibitors have been associated with alterations in levels of LDL and HDL cholesterol, which may lead to dyslipidaemia (an important risk factor for cardiovascular disease). However, the e...

Keywords:

• JAK,
• Meta analysis,
• Review

Riduzione del dolore nei pazienti con artrite reumatoide che usano oppioidi: un'analisi post hoc degli studi di fase 3 su baricitinib

ACR Open Rheumatol. 2021. Epub ahead of print. doi: 10.1002/acr2.11380

Pope JE,

Lee YC,

Curtis JR,

Mo D,

Xie L,

Dickson CL,

Schlichting DE,

Cardoso A,

Simon LS,

Taylor PC

This post hoc analysis shows that pain reduction was similar between opioid users and nonusers with baricitinib 2 mg and 4 mg, but not adalimumab.Use of opioids to treat RA-related pain has increased, yet long-term use has been associated with reduced efficacy and safety concerns. In addition, the misuse of opioids has resulted in a public health crisis in the United States and highlights the need for safe, effective nonaddictive alternatives for pain management. As such, Pope, et al. assessed p...

Keywords:

• JAK,
• Baricitinib,
• Efficacy,
• Pain

Safety of baricitinib for the treatment of rheumatoid arthritis over a median of 4.6 and up to 9.3 years of treatment: final results from long-term extension study and integrated database

Ann Rheum Dis. 2021. Epub ahead of print. doi: 10.1136/annrheumdis-2021-221276.

Taylor PC,

Takeuchi T,

Burmester GR,

Durez P,

Smolen JS,

Deberdt W,

Issa M,

Terres JR,

Bello N,

Winthrop KL

Analysis of data from the highest level of patient exposure to baricitinib across the spectrum of the RA population demonstrates that baricitinib maintained a similar safety profile to earlier analyses, with no new safety signals identified.Using integrated data from nine randomised controlled trials, Taylor, et al. assessed the safety of baricitinib 2 mg and 4 mg once-daily. Analysis of data from 3770 patients (median 4.6 years, up to 9.3 years) with active RA showed that baricitinib maintained...

Keywords:

• JAK,
• Baricitinib,
• Safety,
• LTE

Radiographic progression of structural joint damage over 5 years of baricitinib treatment in patients with rheumatoid arthritis: Results from RA-BEYOND

J Rheumatol. 2021 Sep 15:jrheum.210346.

van der Heijde D,

Kartman CE,

Xie L,

Beattie S,

Schlichting D,

Mo D,

Durez P,

Tanaka Y,

Fleischmann R.

Oral baricitinib maintained lower levels of radiographic progression than initial csDMARD or placebo through 5 years in patients with active RA.It is well known that persistent joint inflammation in RA can lead to irreversible structural damage that impacts on patient physical function and quality-of-life. To this end, van der Heijde, et al. evaluated the effect of baricitinib on inhibiting radiographic progression of structural joint damage over 5 years in patients with active RA. Results from ...

Keywords:

• JAK,
• Baricitinib,
• LTE,
• Efficacy,
• Radiographic

Efficacy and safety of filgotinib in methotrexate-naive patients with rheumatoid arthritis with poor prognostic factors: post hoc analysis of FINCH 3

RMD Open. 2021;7(2):e001621.

Aletaha D,

Westhovens R,

Gaujoux-Viala C,

Adami G,

Matsumoto A,

Bird P,

Messina OD,

Buch MH,

Bartok B,

Yin Z,

Guo Y,

Hendrikx T,

Burmester GR.

Post hoc analysis of the phase III FINCH study shows that filgotinib may be an alternative treatment option for patients with RA who have poor prognostic factors (PPFs), especially those not responding to standard treatment such as methotrexate (MTX).PPFs are associated with severe disease and risk for disease progression in patients with RA. Consequently, the 2019 EULAR management guidelines for RA recommend early treatment escalation for patients with PPFs who have inadequate response to first...

Keywords:

• JAK,
• Fenebrutinib,
• Efficacy,
• Safety,
• Phase 3

La monoterapia con upadacitinib migliora i risultati riportati dai pazienti nell'artrite reumatoide: risultati di SELECT-EARLY e SELECT-MONOTHERAPY

Rheumatology (Oxford). 2021;60(7):3209–21

Strand V,

Tundia N,

Wells A,

Buch MH,

Radominski SC,

Camp HS,

Friedman A,

Suboticki JL,

Dunlap K,

Goldschmidt D,

Bergman M.

Upadacitinib treatment results in statistically significant and clinically meaningful improvements in health-related quality of life.Strand, et al. evaluated the effect of upadacitinib monotherapy versus methotrexate (MTX) on patient-reported outcomes (PRO) in MTX-naïve and MTX-inadequate responder patients with moderately-to-severely active RA. Their research from the SELECT-EARLY and SELECT-MONOTHERAPY randomised controlled trials found that upadacitinib monotherapy resulted in clinically mean...

Keywords:

• JAK,
• Upadacitinib,
• Phase 3,
• PRO / QoL