Upadacitinib Induction and Maintenance Therapy for Crohn’s Disease

N Engl J Med 2023; 388:1966–1980 doi: 10.1056/NEJMoa2212728

Upadacitinib was associated with higher percentages of remission and endoscopic response regardless of previous failure of biologic therapy. This paper reports the Phase 3 efficacy and safety results of upadacitinib in patients with moderate-to-severe Crohn’s disease.

Ozanimod as induction therapy and maintenance therapy for ulcerative colitis

N Engl J Med 2021;385:1280–91 doi: 10.1056/NEJMoa2033617

Patients receiving ozanimod displayed a significant improvement in clinical response and all secondary endpoints during both the 10-week induction and 52-week maintenance study periods. Percentage of patients achieving clinical remission at Weeks 10 and 52 was the primary endpoint.

The results of two induction studies (UC1 and UC2) and a maintenance study (UC3) show upadacitinib superiority to placebo in treating ulcerative colitis (UC). Rates of clinical remission were significantly higher for all upadacitinib doses versus placebo in all three studies.

Treatment of patients with UC with filgotinib 200 mg was associated with an increase in clinical remission at Week 10 and Week 58. The proportion of patients with clinical remission at Week 58 was significantly greater in patients who continued FIL 200 mg therapy throughout the trial. The incidence of TEAEs was similar across all treatment groups.

April 2024

The majority of patients receiving persistent risankizumab therapy achieved clear or clear/almost clear skin at 12 months and patients reported significant reductions in DLQI scores, PROs (fatigue, skin pain, overall itch), and work and activity impairment.

This study by Karakas, et al. found that obesity did not affect secukinumab treatment response and drug retention in ankylosing spondylitis patients.

The 2023 EULAR recommendations provided an updated consensus on the pharmacological management of PsA with a new overarching principle and recommendation for 2023. Recent MOA safety data emphasised the importance of patient-specific benefit-risk profiling in JAKi therapy, and extra-musculoskeletal (MSK) manifestations related to PsA should be considered during drug selection.

Unadjusted time to all-cause discontinuation was significantly longer with baricitinib treatment versus TNFi (estimated median prescription survival time of 704 days versus 448 days; log-rank P<0.01). This difference increased when only comparing differences for b/tsDMARD-naïve patients treated with baricitinib versus tofacitinib.

Researchers reported the safety and efficacy of deucravacitinib over 2 years in patients with chronic plaque PsO. The most frequently reported AEs were nasopharyngitis, URTI, and COVID-19.

Week 16 primary outcomes of improved PASI 90 response and sPGA score demonstrated Mirikizumab superiority to placebo and non-inferiority to secukinumab. This study presented results from the OASIS-2 trial on the safety and efficacy of mirikizumab compared with secukinumab and placebo in patients with moderate-to-severe plaque psoriasis.