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.

Comparing the alignment of European national recommendations for patients with PsA and axSpA with EULAR and ASAS-EULAR treatment recommendations found that only a minority of national treatment recommendations were completely aligned.

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Three-year data from the ixekizumab (IXE) COAST programme provide additional evidence that patients with axSpA receiving IXE experience long-term safety, and sustained improvements in efficacy outcomes, at 3 years.

August 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.

This systematic review identified DMARDs evaluated for axSpA and PsA, distinguishing between csDMARDs, tsDMARDs, and bDMARDs. The review pinpointed twenty-six distinct targeted therapies currently in clinical development; 18 therapies for axSpA and 15 therapies for PsA.

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July 2023

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.

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.

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.

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.

June 2023

This real-world study showed that sustained BASDAI <3 may be a valid and feasible target for a treat-to-target strategy in AxSpA, having function as treatment goal.

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