This meta-analysis by Wei, et al. found that JAKi therapy was not associated with a higher risk of MACE than treatment with adalimumab, abatacept, or placebo. However, a higher incidence of all-cause mortality was observed with tofacitinib treatment than with adalimumab treatment.

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.

Phase IIb study of brepocitinib in patients with PsA concludes that treatment with brepocitinib 30 mg and 60 mg QD, was superior to placebo at reducing signs and symptoms of PsA and was well-tolerated over 52 weeks.

August 2023

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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High paraoxonase activity is associated with a significantly reduced risk of MACE and non-NMSC malignancies in white/European RA patients. The PON1 Q192R RR genotype had a significantly greater association with paraoxonase versus the QQ genotype, but had no significant association with MACE or non-NMSC malignancies.

July 2023

Pots hoc analysis of safety data in patients with RA at increased risk of CV events from the upadacitinib SELECT phase III RA clinical programme helps to contextualise the overall risk profile of upadacitinib.

June 2023

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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May 2023

Secukinumab, an IL-17A monoclonal antibody, was shown to have remarkable efficacy for axSpA in the MEASURE 2 and MEASURE 3 trials. Previous studies have concluded that secukinumab was more efficacious in TNFi-naïve patients.

Evidence from two phase 3 RCTs showed that patients with PsA and axial involvement had greater responses when treated with a once-daily oral dose of 15 mg upadacitinib versus placebo, and a similar or greater response versus adalimumab. Safety results were comparable between patients with or without axial involvement.

April 2023

Retrospective cohort study results suggest that treatment with tofacitinib, and perhaps other JAK inhibitors, may provide a benefit in reducing the risk of developing RA-Interstitial Lung Disease (ILD).