February 2024

Effectiveness of Sequential Lines of Biologic and Targeted Small Molecule Drugs in Psoriatic Arthritis: A Systematic Review

Rheumatology (Oxford). 2024 Jan 18:keae006 doi: 10.1093/rheumatology/keae006 Epub ahead of print

The authors found that there is a reduction in effectiveness of lines of bDMARDs after first-line in PsA, with inadequate data to determine response to tsDMARDs.

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July 2023

Comparative Effectiveness of First-Line Baricitinib in Patients With Rheumatoid Arthritis in the Australian OPAL Data Set

ACR Open Rheumatol. 2023;5(7):345-353 doi 10.1002/acr2.11577

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.

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Tofacitinib versus Methotrexate as the First-line Disease-modifying Antirheumatic Drugs in the treatment of Rheumatoid Arthritis: An Open-label Randomized Controlled Trial

Int J Rheum Dis. 2023;26(9):1729–1736 doi: 10.1111/1756-185X.14801

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.

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August 2022

Incident and Recurrent Herpes Zoster for First-Line bDMARD and tsDMARD Users in Seropositive Rheumatoid Arthritis Patients: A Nationwide Cohort Study

Arthritis Res Ther. 2022;24(1):180

Herpes zoster (HZ) risk is significantly increased in seropositive RA patients with a history of HZ after the initiation of bDMARDs or tsDMARD. It is now well known that the incidence and recurrence of HZ are quite common in patients with RA in real-world clinical settings, yet there is limited evidence regarding bDMARD-dependent HZ risk among patients with a history of HZ prior to bDMARD use.

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June 2022

Persistence and Effectiveness of the IL-12/23 Pathway Inhibitor Ustekinumab or Tumour Necrosis Factor Inhibitor Treatment in Patients with Psoriatic Arthritis: 1-year Results From the Real-world PsABio Study

Ann Rheum Dis 2022 doi: 10.1136/annrheumdis-2021-221640

Many RCTs have demonstrated efficacy and safety of biologics in PsA. However, long term comparative real world data is lacking. This study aimed to evaluate the real-world effectiveness and persistence of the IL-12/23 inhibitor ustekinumab or a TNFi for PsA 1 year post initiation. As a result, they found that PS-adjusted comparisons demonstrated comparable overall persistence, effectiveness and safety for both modes of action in PsA.

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Comparison of drug retention of TNF inhibitors, other biologics and JAK inhibitors in RA patients who discontinued JAK inhibitor therapy

Rheumatology (Oxford) 2022 doi: 10.1093/rheumatology/keac285

Real-world population-based study shows that a switch to a second JAKinib results in a higher drug retention, as compared to switching to a TNFi, in patients with RA who discontinue original JAKinib therapy.

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September 2021

Efficacy and safety of filgotinib in methotrexate-naive patients with rheumatoid arthritis with poor prognostic factors: post hoc analysis of FINCH 3

RMD Open. 2021;7(2):e001621.

Post hoc analysis of the phase III FINCH study shows that filgotinib may be an alternative treatment option for patients with RA who have poor prognostic factors (PPFs), especially those not responding to standard treatment such as methotrexate (MTX).PPFs are associated with severe disease and risk for disease progression in patients with RA. Consequently, the 2019 EULAR management guidelines for RA recommend early treatment escalation for patients with PPFs who have inadequate response to first...

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January 2021

Comparative effectiveness of first-line tumour necrosis factor inhibitor versus non-tumour necrosis factor inhibitor biologics and targeted synthetic agents in patients with rheumatoid arthritis: results from a large US registry study

Ann Rheum Dis 2021;80:96–102.

RA treatment guidelines recommend a treat-to-target approach guided by disease stage and treatment history, yet the optimal sequence of different treatment modalities has not been established. Data from Corrona – were used to evaluate the comparative effectiveness of TNFi versus non-TNFi bDMARDs and tsDMARDs as first-line treatment following csDMARD failure. Results support RA guidelines recommending individualised care based on clinical judgement and consideration of patient preference.The stud...

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November 2018

Efficacy and Safety of Filgotinib, a Selective Janus Kinase 1 Inhibitor, in Patients with Active Ankylosing Spondylitis (TORTUGA): Results from a Randomized, Placebo-controlled, Phase 2 Trial

Lancet 2018 Dec 1;392(10162):2378-2387. DOI 10.1016/S0140-6736(18)32463-2

In this first clinical trial of filgotinib in patients with active AS, filgotinib significantly reduced disease activity, and the signs and symptoms of AS compared with placebo. The TORTUGA trial was a randomized, double-blind, placebo-controlled, Phase 2 trial, that enrolled 263 adult patients from 30 sites in seven countries. Patients with active AS and an inadequate response or intolerance to two or more NSAIDs were assigned 1:1 to receive filgotinib 200 mg or placebo once daily for 12 weeks....

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April 2018

Effectiveness and Safety of Tofacitinib in Rheumatoid Arthritis: a Cohort Study

Arthritis Res Ther 2018; 20(1):60 doi: 10.1186/s13075-018-1539-6

A retrospective cohort study of tofacitinib (TOF) revealed that patients previously treated with methotrexate who initiated TOF, presented no differences in hospitalised infections or effectiveness, compared with non-TNF biologics. Currently, TOF is recommended in ACR and EULAR guidelines as an alternative to biologics after first-line cDMARD therapy. Previous indirect comparisons have shown that patients with RA who experience cDMARD failure show similar efficacy when given TNFis, abatacept, to...

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