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.

February 2025

Miyazaki et al. investigated the efficacy and safety of switching to bDMARDs versus cycling among JAKis in RA patients with inadequate JAKi response. Cycling to another JAKi proved more effective in improving disease activity at 26 weeks compared to switching to a bDMARD, and both groups had similar safety profiles.

Edwards et al. reported that in patients with RA who achieved sustained LDA or remission, tapering baricitinib from 4mg to 2mg allowed most to maintain LDA at 96 weeks. Rescue with 4mg restored control for the majority, demonstrating the feasibility of dose reduction with recovery potential for treatment.

January 2025

Gossec et al. demonstrated that tofacitinib significantly reduced fatigue in patients with ankylosing spondylitis, with median times to clinically meaningful improvements of 8 and 12 weeks for initial and stable improvement events, respectively. These changes were observed as early as two weeks and were more pronounced compared to placebo.

Integrated safety analysis of tofacitinib from Phase 2 and 3 trials of patients with ankylosing spondylitis

Journal Reference: Adv Rheumatol. 2024 Dec 18;64:87 doi: 10.1186/s42358-024-00402-x

Deodhar et al. conducted a pooled analysis of Phase 2 and 3 RCT data to assess the safety of tofacitinib in AS. The results showed that tofacitinib 5 mg BID had a tolerable safety profile over 48 weeks, consistent with its use in other inflammatory conditions such as RA and PsA.

December 2024

Haraoui et al. conducted a subgroup analysis of the CANTORAL study, showing that tofacitinib effectiveness was similar in patients with or without CV risk enrichment. However, AEs, particularly in older patients (≥65 years), were more frequent in the CV+ cohort. These findings highlight the need for tailored CV risk management when treating RA with tofacitinib.

Baricitinib as monotherapy for treatment of rheumatoid arthritis: analysis of real-world data

Current Medical Research and Opinion 2024;40:1993–2002 doi: 10.1080/03007995.2024.2416979.

Edwards et al. report on real-world data for baricitinib monotherapy in rheumatoid arthritis, showing significant disease activity reduction across multiple registries and observational studies. These findings reinforce the viability of baricitinib monotherapy in clinical practice for RA patients, complementing existing guidelines.

November 2024

Impact of treatments on fatigue in axial spondyloarthritis: a systematic review and meta-analysis

Rheumatology (Oxford). 2024 Oct 10:keae549 doi 10.1093/rheumatology/keae549 Epub ahead of print

Delcourt et al. conducted a systematic review and meta-analysis revealing that both pharmacological (DMARDs) and non-pharmacological interventions reduce fatigue in axSpA patients over short and medium terms, with greater efficacy seen when combined.