Post hoc analysis of ORAL Surveillance data highlights that active disease in RA leads to higher risk of adverse medical events, regardless of medication used.

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This multicentre, retrospective study by Hayashi, et al. found no significant differences in efficacy and safety between tofacitinib, baricitinib, peficitinib and upadacitinib in patients with RA. Predictive factors for resistance to LDA achievement included baseline CRP and CDAI for tofacitinib and baseline glucocorticoid dose, baseline CDAI and number of previous b/tsDMARDs for baricitinib.

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.

In this study, Eder, et al. performed a systematic literature review and meta-analysis of RCTs to assess information on participants’ characteristics and rates of American College of Rheumatology response and minimal disease activity by sex. The authors found that the biological sex of patients with PsA influences their response to advanced therapies, but the effect varies by drug class.

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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.

This pooled analysis of the Phase 3 PSO-1 and PSO-2 trials shows that deucravacitinib has greater efficacy in treating scalp PsO than placebo and apremilast. At week 16, response rates were greater with deucravacitinib versus placebo or apremilast for scalp-specific Physician Global Assessment 0/1 and Psoriasis Scalp Severity Index. Efficacy was maintained through 52 weeks in patients who received continuous deucravacitinib treatment.

October 2023

Data gathered from 11 phase 2 and phase 3 trials have shown that guselkumab has a favourable safety profile in treating psoriatic disease. The data were gathered from 4399 patients over 10787 patient years. In the placebo-controlled periods, guselkumab showed a similar safety profile to placebo, and this remained consistent and stable in the non-placebo controlled preiods.

As part of the GBD 2021, the authors provide updated estimates for the global burden of musculoskeletal disorders, excluding RA, osteoarthritis, low back pain, neck pain, and gout. In 2020, the total years lived with disability globally was estimated to be 42.7 million, which was a 122% increase from 1990. Over the same time period, mortality increased by 199%. The study forecasts an increase in cases by 2050 in all regions, with the exception of Central Europe.

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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Risk of Major Adverse Cardiovascular Events in Immune-Mediated Inflammatory Disorders on Biologics and Small Molecules: Network Meta-Analysis

Clin Gastroenterol Hepatol. 2023 Oct 9:S1542-3565(23)00767-X doi 10.1016/j.cgh.2023.09.033 Epub ahead of print

The results of this study show that anti-IL-12/23, JAK inhibitors, and anti-TNF-α were associated with slightly higher risk of MACE compared with placebo. The risk was no different between biologic treatments, and the magnitude of risk did not differ between IMID type.