Efficacy of Pharmacological Interventions: A Systematic Review Informing the 2023 EULAR Recommendations for the Management of Fatigue in People with Inflammatory Rheumatic and Musculoskeletal Diseases
RMD Open 2023;9(4):e003349 doi 10.1136/rmdopen-2023-003349 Epub ahead of print
Adalimumab demonstrated superiority over placebo in reducing fatigue in RA at 12 and 52 weeks. Other interventions, which included golimumab, baricitinib, sarilumab, tocilizumab, and tofacitinib, also proved effective in reducing fatigue in patients with RA. Secukinumab also reduced fatigue by Week 52 in patients with SpA.
Filgotinib Demonstrates Efficacy in Rheumatoid Arthritis Independent of Smoking Status: Post Hoc Analysis of Phase 3 Trials and Claims-Based Analysis)
Rheumatol Ther 2023 doi 10.1007/s40744-023-00619-0 Epub ahead of print
This post hoc analysis by Curtis, et al. found that current and former smokers were more likely to switch from an anti-TNF bDMARD to a different bDMARD or JAK inhibitor in comparison to non-smokers. They also found that DAS28(CRP) ≤3.2 achievement was significantly higher after filgotinib therapy regardless of smoking status in MTX-IR, bDMARD-IR, and MTX-naïve patients.
MACE and VTE across Upadacitinib Clinical Trial Programmes in Rheumatoid Arthritis, Psoriatic Arthritis and Ankylosing Spondylitis
RMD Open 2023; 9(4):e003392 doi 10.1136/rmdopen-2023-003392
Rates of MACE and VTE events in patients with RA or PsA treated are consistent across 15 mg and 30 mg doses of upadacitinib, and comparable with active comparators adalimumab and MTX. Several risk factors were also identified for MACE and VTE events in patients with RA.
Malignancy in the Upadacitinib Clinical Trials for Rheumatoid Arthritis, Psoriatic Arthritis, Ankylosing Spondylitis, and Non-radiographic Axial Spondyloarthritis
Rheumatol Ther 2023;11(1):97–112 doi 10.1007/s40744-023-00621-6
Rates of malignancy were similar between upadacitinib, adalimumab, and MTX. They were also consistent across RA, PsA, AS and nr-axSpA. A dose-dependent increased rate of NMSC was observed with upadacitinib in RA. For RA and PsA, being older (≥65 years) and male was associated with
an increased risk of malignancy excluding NMSC.
One-Year Medication Adherence and Persistence in Rheumatoid Arthritis in Clinical Practice: A Retrospective Analysis of Upadacitinib, Adalimumab, Baricitinib, and Tofacitinib
Adv Ther. 2023;40(10):4493–4503 doi 10.1007/s12325-023-02619-6
This study by Bergman, et al. showed that RA patients are significantly more likely to adhere to upadacitinib within the first 12 months of prescription versus adalimumab, baricitinib, and tofacitinib. There was also a significantly lower risk of discontinuation for upadacitinib versus the other treatment prescriptions.
Cardiovascular Safety of Janus Kinase Inhibitors in Patients with Rheumatoid Arthritis: Systematic Review and Network Meta-analysis
Front Pharmacol. 2023; 8(14):1237234 doi 10.3389/fphar.2023.1237234
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.
Filgotinib Modulates Inflammation-Associated Peripheral Blood Protein Biomarkers in Adults with Active Rheumatoid Arthritis and Prior Inadequate Response to Methotrexate
Rheumatol Ther. 2023;10(5):1335–1348 doi 10.1007/s40744-023-00583-9
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.
Incidence of Interstitial Lung Disease in Patients with Rheumatoid Arthritis Treated With Biologic and Targeted Synthetic Disease-Modifying Antirheumatic Drugs
JAMA Netw Open. 2023;6(3):e233640 doi: 10.1001/jamanetworkopen.2023.3640
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).
Enthesitis in Patients with Psoriatic Arthritis Treated with Secukinumab or Adalimumab: a post hoc Analysis of the EXCEED Study
Rheumatology (Oxford).2023;kead181. doi 10.1093/rheumatology/kead181.
Results from the 52-week phase 3 EXCEED study showed that secukinumab and adalimumab both display similar efficacy in time to resolution of enthesitis, in patients with PsA, irrespective of baseline enthesitis severity and individual site distribution.
Efficacy and Safety of Upadacitinib in Patients with Active Psoriatic Arthritis and Axial Involvement: Results From Two Phase 3 Studies
Arthritis Res Ther. 2023;25(1):56 doi 10.1186/s13075-023-03027-5
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.