Phase 3 trial of baricitinib demonstrates efficacy with acceptable safety profile in polyarticular and extended oligoarticular juvenile idiopathic arthritis, juvenile psoriatic arthritis and enthesitis-related arthritis.

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.

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.

June 2023

This single-centre study by Khan, et al. suggests that high-dose methotrexate (25 mg/week, subcutaneously) may be as efficacious as tofacitinib in patients with established RA who are DMARD naïve or have not received a therapeutic dose of DMARDs.

The study demonstrated that obesity is a factor that could play a role in treatment decision-making in people living with inflammatory arthritis (IA). It appears that efficacy of TNFi is affected by patients’ weight/BMI in all forms of IA, while this is not the case for TCZ and ABA in RA, as well for IL-17 and IL-23 inhibitors in PsA.

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JAK Inhibitors and the Risk of Malignancy: A Meta-analysis Across Disease Indications

Ann Rheum Dis. 2023;82(8):1059–1067 doi: 10.1136/ard-2023-224049

The objective of this study was to estimate the association of JAKi with the incidence of malignancy, compared with placebo, TNFi and MTX.

The results from Simon, et al. show that baricitinib treatment correlates with improvements in bone stiffness. Further improvements were also observed at the end of Week 52, with an increase in estimated failure load and no measurable progression in bone erosion being reported.

Reinisch, et al. show that filgotinib treatment has no effect on semen parameters for men with active inflammatory diseases. This contrasts with pre-clinical studies that showed fertility issues in male animals.

Kristensen, et al. used mediation modelling to show that tofacitinib indirectly improved fatigue symptoms via back pain and morning stiffness. This study was carried out using FACIT-F- and BASDAI Q1-based models to determine the relationship between these variables.

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.