Phase 2 Trial of Anti-TL1A Monoclonal Antibody Tulisokibart for Ulcerative Colitis

N Engl J Med. 2024;391:1119-1129 doi: 10.1056/NEJMoa23140

Sands et al. demonstrated that 12-week treatment of tulisokibart, a monoclonal antibody targeting TL1A, significantly improved clinical remission rates compared to placebo in patients with moderate-to-severe ulcerative colitis.

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Efficacy of Janus kinase inhibitors in the treatment of psoriasiform atopic dermatitis

Clin Exp Dermatol. 2024 Sep 18;49:1232-1234 doi: 10.1093/ced/llae16

Napolitano et al. conducted a retrospective analysis on patients with moderate-to-severe psoriasiform atopic dermatitis (AD) treated with JAK inhibitors, showing significant improvements in disease severity scores (EASI, P-NRS, DLQI) by Week 4, with 95% of patients achieving EASI-75 and 86% achieving EASI-90 by Week 24.

Su et al. conducted a comprehensive systematic review and network meta-analysis to assess the efficacy and safety of therapies for difficult-to-treat (D2T) RA. They found that tocilizumab and rituximab had superior efficacy and safety profiles, with 8mg every 4 weeks of tocilizumab identified as the optimal therapeutic dose.

Kandeel et al. compared JAK inhibitors and TNF inhibitors in RA. JAK inhibitors demonstrated better functional improvement via HAQ-DI but showed insignificant difference in CDAI compared to TNF inhibitors; both classes had similar safety.

September 2024

Peyrin-Biroulet et al. evaluated the efficacy and safety of etrasimod in patients with moderately to severely active isolated proctitis, demonstrating significant improvement in clinical outcomes compared to placebo. The study reported a favourable safety profile, making etrasimod a viable treatment option for this population.

Pacheco et al. demonstrated that, compared with axSpA patients who respond to secukinumab,  patients who do not respond show increased IL-17A-producing cells and have a more pronounced type 1 IFN signature, indicating a larger inflammatory burden.

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.

Adami et al. conducted a retrospective analysis to evaluate the GC sparing effects of JAKi versus bDMARDs in rheumatoid arthritis patients. They found that JAKi therapy was associated with a significant reduction in GC dose compared with bDMARDs. This suggests that JAKi could be more effective in reducing long-term GC exposure in RA patients.

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August 2024

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.

July 2024

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.