Zavoriti and Miossec explored the impact of tofacitinib on inflammation and coagulation in RA. Tofacitinib reduced synovial and vascular inflammation by inhibiting IFNɣ, IL-17A, and IL-6 production but failed to prevent the prothrombotic effects of inflammatory cytokines on endothelial cells. These findings suggest that while tofacitinib reduces inflammation, it does not mitigate associated thrombotic risk.

Kanda et al. investigated the efficacy of second-line b/tsDMARDs in RA patients unresponsive to first-line b/tsDMARDs. Using data from the FIRST registry, the study assessed 687 patients with RA treated with TNFis, IL-6 receptor inhibitors, cytotoxic T-lymphocyte-associated protein 4 immunoglobulin, or JAKis. After propensity score-based adjustment, JAKi showed the highest persistence rate, greatest improvement in CDAI, and highest remission rates at 24 weeks. Among JAKi, UPA was most effective in achieving remission, with a safety profile comparable to other b/tsDMARDs.

Eberhard et al. investigated the effectiveness of JAKi versus bDMARDs on pain reduction in RA patients, using Swedish national register data. JAKi treatment resulted in a significantly greater reduction in pain at three months compared with TNFis, with a higher proportion achieving low pain at 12 months, particularly in those previously treated with multiple bDMARDs.

October 2024

Su et al. conducted a comprehensive systematic review and network meta-analysis to assess the efficacy and safety of therapies for difficult-to-treat (D2T) RA. They found that tocilizumab and rituximab had superior efficacy and safety profiles, with 8mg every 4 weeks of tocilizumab identified as the optimal therapeutic dose.

July 2024

Tofacitinib in acute severe ulcerative colitis (TACOS): A randomized controlled trial

Journal Reference: Am J Gastroenterol 2024;119:1365–72 doi: 10.14309/ajg.0000000000002635

A combination of tofacitinib and corticosteroids improved treatment responsiveness and decreased the need for rescue therapy in patients with acute severe ulcerative colitis (ASUC). Singh et al. investigated whether addition of tofacitinib to corticosteroids was superior to corticosteroids alone in patients hospitalised with ASUC.

The outcomes of children born to mothers with autoimmune rheumatic diseases

Lancet Rheumatol 2024:S2665-9913(24)00096-1 doi: 10.1016/S2665-9913(24)00096-1 Epub ahead of print

This Series paper by Andreoli, et al. provides a comprehensive overview of the literature for pregnancy outcomes for mothers with autoimmune rheumatic disease, and provides guidance on discussing these topics with patients. They also provide a list of frequently asked questions related to pregnancy and children by women with autoimmune rheumatic diseases.

May 2024

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.

November 2023

Effects of 1-year Tofacitinib Therapy on Angiogenic Biomarkers in Rheumatoid Arthritis

Rheumatology (Oxford) 2023; 62(SI3):SI304–SI312 doi 10.1093/rheumatology/kead502

This study by Kerekes, et al. investigated the relationship between tofacitinib therapy, angiogenic biomarker levels, and vascular inflammation and function in RA patients. The authors found that tofacitinib treatment reduced the production of bFGF, PlGF and IL-6, which may inhibit synovial and aortic inflammation.

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August 2023

This study by Tanaka, et al. shows that filgotinib reduces peripheral protein biomarkers associated with JAK/STAT signalling, inflammatory signalling, immune cell migration, and bone resorption in RA patients. Notably, filgotinib 200 mg significantly reduced IL-6, TNF, CXCL13 levels as early as Week 4.

September 2022

Olokizumab versus Placebo or Adalimumab in Rheumatoid Arthritis

N Engl J Med. 2022;387(8):715–726. doi: 10.1056/NEJMoa2201302

Phase 3 trial of olokizumab, a direct inhibitor of the IL-6 ligand, demonstrates superiority to placebo with respect to an ACR20 response at week 12 and noninferiority to adalimumab (all combined with methotrexate), in patients with RA.