Publications

Upadacitinib は従来型抗リウマチ薬が効果不十分な関節 リウマチ患者の患者報告アウトカムを改善する: SELECT-NEXT 試験結果

Arthritis Res Ther . 2019 Dec 9;21(1):272.

Strand V,

Pope J,

Tundia N,

Friedman A,

Camp H,

Pangan A,

Ganguli A,

Fuldeore M,

Goldschmidt D,

Schiff M

In SELECT-NEXT, UPA demonstrated clinically meaningful improvements in patient reported outcomes compared to PBO in patients with RA who had an inadequate response to csDMARDs. In this post hoc analysis, the effect of UPA 15 or 30 mg on patient reported outcomes were assessed and compared to PBO.Eligible patients (661) with an inadequate response to csDMARDs were randomly assigned 2:2:1:1 to receive background csDMARD therapy with either UPA 15 mg, UPA 30 mg or PBO. PROs collected at Wk4 and Wk1...

Keywords:

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

Highlights of 2019

Please click the links below to go to the CSF review of each paper

McInnes. I

2019 was another remarkable year in cytokine signalling. We can be optimistic that clinical practice for inflammatory arthritis will continue to improve, with promising long-term safety data supporting the use of established JAK inhibitors; tofacitinib and baricitinib, in addition to exciting phase III clinical data for filgotinib and newly approved upadacitinib. You can find the most notable papers, as selected by CSF Steering Committee Chair Professor Iain McInnes, with links to their respecti...

Keywords:

• Review

フェーズ2と3試験におけるウパダシチニブの曝露と反応性に 関する有効性安全性解析 関節リウマチにおけるベネフィットリスク

Clin Pharmacol Ther . 2020 Apr;107(4):994-1003. doi: 10.1002/cpt.1671.

Nader A,

Mohamed M-EF,

Winzenborg I,

Doelger E,

Noertersheuser P,

Pangan AL,

Othman AA

UPA 15 mg provided the optimal benefit-risk in RA through maximizing efficacy with only small incremental benefit with 30 mg, and with consistency across RA subpopulations and with UPA monotherapy or combination with csDMARDs. Exposure-response analyses were conducted using combined data from two Phase 2b and five Phase 3 studies in order to characterise the relationship between plasma exposure and efficacy, as well as to select safety parameters using the totality of the data in subjects with R...

Keywords:

• JAK,
• Upadacitinib,
• Efficacy,
• Safety

Baricitinib, Upadacitinib および Tofacitinib を介したヒト白血球 分画におけるサイトカインシグナルの比較

Arthritis Res Ther. 2019 Aug 2;21(1):183

McInnes IB,

Byers NL,

Higgs RE,

Lee J,

Macias WL,

Na S,

Ortmann RA,

Rocha G,

Rooney TP,

Wehrman T,

Zhang X,

Zuckerman SH,

Taylor PC

Different JAKinibs modulated distinct cytokine pathways to varying degrees, and no agent potently or continuously inhibited an individual cytokine signalling pathway throughout the dosing interval. This study aimed to compare the in vitro cellular pharmacology of BARI, TOF and UPA across relevant leukocyte subpopulations, coupled with their in vivo PK, to determine their effects on distinct cytokine pathways. Peripheral blood mononuclear cells from healthy donors were incubated with different JA...

Keywords:

• JAK,
• Baricitinib,
• Tofacitinib,
• Upadacitinib,
• MOA

メトトレキサートに効果不十分な関節リウマチ患者における Upadacitinib 対 Placebo または Adalimumab : フェーズ3, 二 重盲検, 無作為化対照試験結果

Arthritis Rheumatol 2019 DOI: 10.1002/art.41032

Fleischmann R,

Pangan AL,

Song IH,

Mysler E,

Bessette L,

Peterfy C,

Durez P,

Ostor AJ,

Li Y,

Zhou Y,

Othman AA,

Genovese MC

UPA demonstrated superiority to ADA in terms of clinical, functional and patient-reported outcomes with comparable radiographic inhibition. As many RA patients fail to achieve LDA and remission with TNF inhibitors and MTX there is a requirement for additional treatment options. In this SELECT-COMPARE study the clinical and functional outcomes of UPA were compared to ADA in MTX-IR patients. 1629 MTX-IR were randomly assigned 2:2:1 to; UPA 15mg QD, ADA 40mg Q2W or PBO, with background MTX. Key end...

Keywords:

• JAK,
• Upadacitinib,
• Phase 3

関節リウマチ患者におけるメトトレキサート併用下かつ効果 不十分例でスイッチした際のUpadacitinib または Adalimumab の48週安全性と有効性

Ann Rheum Dis 2019 DOI: 10.1136/annrheumdis-2019-215764

Fleischmann RM,

Genovese MC,

 Enejosa JV,

 Mysler E,

Bessette L,

Peterfy C,

 Ostor P,

 Li Y,

 Song I

Consistent with Wk26 data, significantly more UPA patients achieved LDA and remission versus ADA and PBO over 48 weeks. RA patients often change therapy due to inadequate response and intolerance. The SELECT COMPARE study was designed to explore switching to JAK inhibitors from TNF inhibitors without a wash-out period (and vice versa). The long-term safety and efficacy of UPA was compared to ADA and PBO in MTX-IR.1629 patients were blindly assigned 2:2:1 to; UPA 15mg QD, ADA 40mg Q2W and PBO, wi...

Keywords:

• JAK,
• Upadacitinib,
• Phase 3

メトトレキサートで効果不十分な活動性関節リウマチに対するウパダシチニブ単剤治療 (SELECT-MONOTHERAPY): 無作為化プラセボ対照二重盲検フェーズ３試験

Lancet. 2019 Jun 8;393(10188):2303-2311

Smolen JS,

Pangan AL,

Emery P,

Rigby W,

Tanaka Y,

Vargas JI,

Zhang Y,

Damjanov N,

Friedman A,

Othman AA,

Camp HS,

Cohen S

UPA monotherapy showed statistically significant improvements in clinical and functional outcomes versus continuing MTX in MTX inadequate-responder patients with RA. Despite its proven effectiveness and safety, many patients are unable to tolerate MTX due to its side-effects. Therapies that can be used without concomitant MTX therefore, have an important place in RA management. In previous studies, UPA has shown efficacy in combination with stable background csDMARDs in RA patients who are DMARD...

Keywords:

• JAK,
• Upadacitinib,
• Phase 3

Professor Iain McInnes Reviews the Most Notable Papers from 2018

Please click the links below to go to the CSF review of each paper

McInnes. I

2018 brought a wealth of new data in cytokine signalling and IL-6 that helps inform current clinical practice and brings the promise of new options in the future. There was good data on the use of sub cutaneous tocilizumab as well as strategies in early RA and for methotrexate tapering. For the currently marketed JAK inhibitors, tofacitinib and baricitinib, continuous long-term efficacy and safety data further support its current use and applications. On the development side, the outcomes of the...

Keywords:

• Review

生物学的抗リウマチ薬に抵抗性の活動性関節リウマチ患者におけるウパダシチニブの安全性と有効性 (SELECT-BEYOND): 二重盲検, 無作為化対照フェーズ 3 治験

Lancet 2018;391:2513–24

Genovese MC,

Fleischmann R,

Combe B,

Hall S,

Rubbert-Roth A,

Zhang Y,

Zhou Y,

Mohamed M-EF,

Meerwein S,

Pangan AL

Upadacitinib (UPA) extended release formulation was effective in treating patients with moderate-to-severe RA with an inadequate response to bDMARDs.Phase 2 study data has shown that UPA is an efficacious and safe treatment for active RA.1,2 SELECT-BEYOND was a double-blind, long-term extension, Phase 3 study to assess the efficacy of UPA in patients with RA who were bDMARD-IR. The first 12-weeks of SELECT-BEYOND were placebo-controlled, with a double-blind period followed by an ongoing double-b...

Keywords:

• JAK,
• Upadacitinib,
• Phase 3

従来型抗リウマチ薬に効果不十分な関節リウマチ患者におけるウパダシチニブの安全性と有効性 (SELECT-NEXT): 無作為化二重盲検プラセボ対照フェーズ3治験

Lancet 2018;391:2503–12

Burmester GR,

Kremer JM,

Van den Bosch F,

Kivitz A,

Bessette L,

Li Y,

Zhou Y,

Othman AA,

Pangan AL,

Camp HS

Patients with moderate-to-severe active RA had significant improvements in clinical signs and symptoms with upadacitinib (UPA) compared with placebo.In Phase 2 studies, UPA showed favourable efficacy when administered twice daily as an immediate-release formulation at doses of 6–12 mg in patients with active RA who had TNFi-IR.1,2 An extended-release formulation allowing once-daily (QD) administration was developed for Phase 3 studies. SELECT-NEXT was a double-blind, multicentre, Phase 3 study t...

Keywords:

• JAK,
• Upadacitinib,
• Phase 3