December 2024

Sustained response to guselkumab regardless of baseline characteristics in patients with active psoriatic arthritis and inadequate response to TNF inhibitors: results from the phase 3b COSMOS clinical trial

RMD Open. 2024 Dec 12;10(4):e004494. doi: 10.1136/rmdopen-2024-004494.

McInnes et al. assessed the efficacy of guselkumab over 48 weeks in patients with psoriatic arthritis who had an inadequate response to TNF inhibitors. The results demonstrated consistent improvements in joint, skin, and patient-reported outcomes across all baseline-defined subgroups. Guselkumab showed greater efficacy compared with placebo at Week 24, with responses maintained or improved through Week 48.

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Efficacy and safety of mirikizumab in patients with moderately-to-severely active Crohn’s disease: a phase 3, multicentre, randomised, double-blind, placebo-controlled and active-controlled, treat through study

Lancet 2024;404:2423–36 doi: 10.1016/S0140-6736(24)01762-8

Ferrante et al. conducted a phase 3 trial evaluating the efficacy and safety of mirikizumab in patients with moderately-to-severely active Crohn’s disease. The study demonstrated that mirikizumab significantly improved clinical and endoscopic outcomes compared with placebo at week 52, with a favourable safety profile and tolerable adverse events.

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Indirect comparison of deucravacitinib and other systemic treatments for moderate to severe plaque psoriasis in Asian populations: A systematic literature review and network meta-analysis

J Dermatol. 2024;51:1559–1571 doi: 10.1111/1346-8138.17448

Tsai et al. conducted a systematic literature review and network meta-analysis evaluating deucravacitinib and other systemic treatments for moderate-to-severe plaque psoriasis in Asian populations. The authors reported that deucravacitinib achieved PASI75 and PASI90 response rates of 66% and 40%, respectively, higher than placebo and apremilast.

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Sustained DMARD-free remission in subgroups of patients with rheumatoid arthritis: an analysis of two prospective cohorts with early arthritis

Lancet Rheumatol 2024 doi: 10.1016/S2665-9913(24)00234-0

Heutz et al. found that patients requiring bDMARDs rarely achieved DMARD-free remission, while 15–37% of those on non-bDMARDs reached this milestone, underscoring significant differences based on treatment type. This suggests the EULAR recommendation against DMARD cessation may be too generalised.

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November 2024

Interleukin-23 vs. interleukin-12/23 inhibitors on preventing incidental psoriatic arthritis in patients with psoriasis? A real-world comparison from the TriNetX Global Collaborative Network

J Am Acad Dermatol 2024 Nov;91:889–895 doi: 10.1016/j.jaad.2024.07.1473

Tsai et al. observed no significant difference in the incidence of psoriatic arthritis among psoriasis patients treated with IL-23 inhibitors compared to IL-12/23 inhibitors, although there was a numerically lower PsA risk with IL-23 inhibitors. Results indicate both therapies are similarly effective for PsO management.

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Fenofibrate as an Adjunct Therapy for Ulcerative Colitis: Targeting Inflammation via SIRT1, NLRP3, and AMPK Pathways: A Randomized Controlled Pilot Study

Drug Des Devel Ther. 2024;18:5239-5253. doi 10.2147/DDDT.S490772

Alarfaj et al. demonstrate fenofibrate significantly improved clinical outcomes, inflammatory biomarkers, and quality of life in patients with mild-to-moderate UC when added to mesalamine therapy.

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Persistent patient-level effect of guselkumab at consecutive 8-week dosing visits and over time in patients with active psoriatic arthritis: post hoc analysis of a 2-year, Phase 3, randomized, controlled study

ACR Open Rheumatol. 2024 doi 10.1002/acr2.11732 Epub ahead of print

Mease et al. conducted a post-hoc analysis of the phase 3 DISCOVER-2 trial to assess the persistence of clinically relevant improvements with guselkumab in biologic-naïve patients with PsA. The analysis showed that guselkumab maintained clinical improvements in joint and skin domains at consecutive dosing visits (Q8W) and over time.

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Efficacy and safety of upadacitinib in patients with active ankylosing spondylitis refractory to biologic therapy: 2-year clinical and radiographic results from the open-label extension of the SELECT-AXIS 2 study

Arthritis Res Ther. 2024 12;26:197 doi 10.1186/s13075-024-03412-8

Baraliakos et al. assessed the long-term efficacy and safety of upadacitinib in patients with active ankylosing spondylitis who were refractory to biologic therapy. At week 104, the treatment sustained improvements in disease activity and functional outcomes with low rates of radiographic progression and no new safety signals.

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Development of extra-musculoskeletal manifestations in upadacitinib-treated patients with psoriatic arthritis or axial spondyloarthritis

Arthritis & Rheumatology 2024. Epub ahead of print doi: 10.1002/art.43069

Poddubnyy et al. analysed five clinical trials to evaluate extra-musculoskeletal manifestations (EMMs) like uveitis, IBD, and psoriasis in patients treated with UPA. They observed low incidences across PsA, r-axSpA, and nr-axSpA. Numerically, uveitis rates were lower in
UPA-treated patients than in those receiving placebo, particularly in r-axSpA.

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Barriers to CAR T-cell therapy in rheumatology

Lancet Rheumatol 2024 doi: 10.1016/S2665-9913(24)00240-6

Lungova et al. explored the potential of CAR T-cell therapy in autoimmune conditions such as SLE, myopathies, and systemic sclerosis. While clinical cases show promise, adoption is limited by high costs, narrow patient eligibility, and safety concerns, including cytokine release syndrome. Future targeted CAR T-cell approaches may enhance efficacy and safety.

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