Lipid profile changes in patients with chronic inflammatory arthritis treated with biologics and tofacitinib in randomized clinical trials: A systematic review and meta-analysis

Arthritis Rheumatol. 2015;67(1):117–127

Souto A,

Salgado E,

Maneiro JR,

Mera A,

Carmona L,

Gómez-Reino JJ

Systemic inflammation, reflected by high levels of C-reactive protein and the erythrocyte sedimentation rate, has been identified as an independent risk factor for cardiovascular disease, the most important cause of death in RA and SpA. Studies with TNF antagonists have given contradictory results on cardiovascular risk. As such, this systemic literature search aimed to analyse lipid changes in RA and SpA subjects treated with biologics or tofacitinib in randomized clinical trials.

The s...

Keywords:

• JAK,
• Tofacitinib,
• Safety,
• Cardiovascular

An evaluation of risk factors for major adverse cardiovascular events during tocilizumab therapy

Arthritis Rheumatol. 2015;67(2):372–380

Rao VU,

Pavlov A,

Klearman M,

Musselman D,

Giles JT,

Bathon JM,

Sattar N,

Lee JS

The risk of cardiovascular (CV) disease among RA patients, compared with the general population is well documented. Alongside this, studies have been able to establish that risk factors in RA patients are not wholly associated with traditional CV risk factors such as such as diabetes mellitus, hypertension, smoking, and dyslipidemia, suggesting a relationship between parameters of RA disease activity and increased CV risk. Additionally, IL-6 has been linked with the development of coronary heart...

Keywords:

• IL-6,
• Tocilizumab,
• Safety,
• Cardiovascular

Combined inhibition of TNFα and IL-17 as therapeutic opportunity for treatment in rheumatoid arthritis: Development and characterization of a novel bispecific antibody

Arthritis Rheumatol. 2015;67(1):51–62

Fischer JA,

Hueber AJ,

Wilson S,

Galm M,

Baum W,

Kitson C,

Auer J,

Lorenz S,

Moelleken J,

Bader M,

Tissot AC,

Tan SL,

Seeber S,

Schett G

Single cytokine inhibition, e.g. TNFα or IL-6, has fundamentally improved the therapeutic armamentarium for the treatment of RA; yet clinically meaningful responses are achieved in only about half of RA patients treated. In addition, it is now well established that the pathogenesis of RA involves multiple mechanisms of cell activation and cell recruitment. These two factors have led to the emergence of the concept of dual specificity, sparking interest in the biologic arena, with a focus o...

Keywords:

• IL-17,
• TNF

Tofacitinib with methotrexate in third-line treatment of patients with active rheumatoid arthritis: Patient-reported outcomes from a Phase 3 trial

Arthritis Care Res (Hoboken). 2014 Sep 3. doi: 10.1002/acr.22453. [Epub ahead of print]

Strand V,

Burmester GR,

Zerbini CA,

Mebus CA,

Zwillich SH,

Gruben D,

Wallenstein GV

For many patients with rheumatoid arthritis, improvements in pain, physical function, fatigue, and health-related quality of life (HRQoL) are more important and meaningful than improvements in joint swelling, tenderness, or inhibition of structural damage. These patient-perceived benefits of RA therapy contribute importantly to overall clinical efficacy.

This paper presents patient-reported outcomes (PROs) form the ORAL Step trail, which assessed tofacitinib 5 mg or 10 mg twice daily, or ...

Keywords:

• JAK,
• Tofacitinib,
• Phase 3

The active metabolite of spleen tyrosine kinase inhibitor fostamatinib abrogates the CD4+T cell-priming capacity of dendritic cells

Rheumatology (Oxford). 2015;54(1):169–177

Platt AM,

Benson RA,

McQueenie R,

et al.

SYK is a core signalling protein that drives inflammatory responses and is fundamental to the propagation of signals via numerous immune receptors. While the clinical development of the first SYK inhibitor, fostamatinib, was stopped due to poor results in the phase 3 RA programme, there remain important questions of mechanism which may aid future developments of this target.

In these murine studies, investigators sought to gain an understanding of how the active metabolite of fostamatini...

Keywords:

• SYK,
• Preclinical

Secukinumab in Plaque Psoriasis — Results of Two Phase 3 Trials

N Engl J Med. 2014;371(4):326–338.

Langley RG,

Elewski BE,

Lebwohl M,

et al.

Secukinumab is a fully human monoclonal antibody that selectively binds to and neutralises interleukin-17A, a cytokine shown to play a crucial role in plaque psoriasis, as well as other immune-mediated diseases.

These two pivotal phase 3 studies in plaque psoriasis, FIXTURE and ERAUSRE, were sponsored by Novartis Pharmaceuticals. Secukinumab met all primary endpoints, PASI 75 response and the response of 0 or 1 on the modified investigator’s global assessment, as well as key secondary end...

Keywords:

• IL-17,
• Secukinumab,
• Phase 3

Changes in serum creatinine in patients with active rheumatoid arthritis treated with tofacitinib: results from clinical trials

Arthritis Res Ther. 2014;16(4):R158

Isaacs JD,

Zuckerman A,

Krishnaswami S,

et al.

Despite preclinical and healthy volunteer studies of tofacitinib showing no evidence of nephrotoxicity, increases in mean serum creatinine levels have been observed in patients treated with the drug during the RA clinical development programme. This report explores the clinical significance of this change.

Serum creatinine values and renal adverse event data were pooled from patients who received =1 dose of tofacitinib either with background DMARDs or as monotherapy in five Phase 3 studie...

Keywords:

• JAK,
• Tofacitinib,
• Safety,
• Renal

Analysis of Infections and All-Cause Mortality in Phase II, III and Long-Term Extension Studies of Tofacitinib in Patients with Rheumatoid Arthritis

Arthritis Rheumatol. 2014;66(11):2924–2937

Cohen S,

Radominski SC,

Gomez-Reino JJ,

et al.

This study pools data from the global tofacitinib RA development programme (phase II, phase III and long-term extension studies) to determine the rate of infections and all-cause mortality with tofacitinib treatment. In total, 4,789 patients within these studies received tofacitinib, at varying doses and with varying duration.

The overall incidence rate of serious infections was 3.09 events/100 patient-years (95% CI 2.73–3.49), which was stable over time, with pneumonia and skin and soft...

Keywords:

• JAK,
• Tofacitinib,
• Safety,
• Phase 3,
• LTE,
• Mortality,
• Infections

Herpes Zoster and Tofacitinib Therapy in Patients with Rheumatoid Arthritis

Arthritis Rheumatol. 2014 Jun 18. [Epub ahead of print]

Winthrop KL,

Yamanaka H,

Valdez H,

et al.

It is well established that patients with RA are at an increased risk of herpes zoster (HZ). What is less well known is whether some of the newer therapies available for treatment of RA increase this risk. Tofacitinib has been reported to be associated with an increased risk of HZ and this study quantifies that risk and reviews potential factors that represent an increased risk. Using data from the tofacitinib RA development programme; phase 2, 3, and long-term extension clinical trials, over 20...

Keywords:

• JAK,
• Tofacitinib,
• Safety,
• Infections

Nociceptive sensory neurons drive interleukin-23-mediated psoriasiform skin inflammation

Nature. 2014;510(7503):157–161.

Riol-Blanco L,

Ordovas-Montanes J,

Perro M,

et al.

The abnormal activation of skin immune cells, such as dermal dendritic cells (DDCs) and interleukin (IL)-17-producing γδ T (γδT17) cells, by IL-23 is known to provoke psoriasis-type inflammation. What is less well known is how peripheral nerves regulate cutaneous immune responses. In this study, IL-23-dependent psoriasis-like inflammation was induced in mice to help determine the precise molecular mechanism of neuroimmune communication in the skin. Findings indicate nocic...

Keywords:

• Preclinical,
• MOA