Can Patients with Controlled Rheumatoid Arthritis Taper Methotrexate From Targeted Therapy and Sustain Remission? A Systematic Review and Meta-analysis
J Rheumatol. 2023;50(1):36–47 doi: 10.3899/jrheum.220152
This systematic review and meta-analysis of studies evaluated the proportion of patients in remission after the dosage of MTX was tapered, and concludes that patients with controlled RA may taper MTX from targeted therapy with a 10% reduction in the ability to sustain remission for up to 18 months.
Analysis of Disease Activity Metrics in a Methotrexate Withdrawal Study among Patients with Rheumatoid Arthritis Treated with Tofacitinib plus Methotrexate
Rheumatol Ther. 2022. Epub ahead of print doi: 10.1007/s40744-022-00511-3
This post hoc analysis of data from the ORAL Shift study, concludes that DAS28-4(ESR), CDAI remission and SDAI remission are the metrics most likely to reflect actual disease activity, in the context of tofacitinib in a randomised withdrawal of MTX.
Efficacy and Safety of Filgotinib in Patients with High Risk of Poor Prognosis Who Showed Inadequate Response to MTX: A Post Hoc Analysis of the FINCH 1 Study
Rheumatol Ther. 2022. Epub ahead of print doi: 10.1007/s40744-022-00498-x
Post hoc analysis from the FINCH 1 study highlights filgotinib as a potential beneficial treatment option for patients with RA who have had inadequate response to MTX and have high risk of disease progression and poor prognosis.
Impact of initial therapy with upadacitinib or adalimumab on achievement of 48-week treatment goals in patients with rheumatoid arthritis: post hoc analysis of SELECT-COMPARE
Rheumatology (Oxford). 2022. Epub ahead of print doi: 10.1093/rheumatology/keac477
Post hoc analysis findings provide the first data evaluating the importance of treatment order with JAKinib vs TNFi as initial therapy, suggesting that a JAKinib first strategy leads to more rapid improvements in treatment outcomes following csDMARD failure.
Efficacy and safety of ixekizumab in patients with active psoriatic arthritis with and without concomitant conventional disease‑modifying antirheumatic drugs: SPIRIT‑P1 and SPIRIT‑P2 3‑year results
Clin Rheumatol. 2022 doi: 10.1007/s10067-022-06218-8
In this investigation ixekizumab showed sustained efficacy in PsA therapy for up to three years in both monotherapy and combination with MTX or a csDMARD. Here, investigators set out to evaluate the three-year efficacy and safety of ixekizumab with and without csDMARD use in patients with active PsA.
Unincreased risk of hospitalized infection under targeted therapies versus methotrexate in elderly patients with rheumatoid arthritis: a retrospective cohort study
Arthritis Res Ther. 2022 doi: 10.1186/s13075-022-02807-9
Retrospective, longitudinal, population-based study shows that despite an overall higher incidence of hospitalised infection (HI) in both elderly and older elderly patients compared to young patients, the risks of HI in patients exposed to targeted therapy versus MTX is not significantly increased.
Persistence and Effectiveness of the IL-12/23 Pathway Inhibitor Ustekinumab or Tumour Necrosis Factor Inhibitor Treatment in Patients with Psoriatic Arthritis: 1-year Results From the Real-world PsABio Study
Ann Rheum Dis 2022 doi: 10.1136/annrheumdis-2021-221640
Many RCTs have demonstrated efficacy and safety of biologics in PsA. However, long term comparative real world data is lacking. This study aimed to evaluate the real-world effectiveness and persistence of the IL-12/23 inhibitor ustekinumab or a TNFi for PsA 1 year post initiation. As a result, they found that PS-adjusted comparisons demonstrated comparable overall persistence, effectiveness and safety for both modes of action in PsA.
Comparison of drug retention of TNF inhibitors, other biologics and JAK inhibitors in RA patients who discontinued JAK inhibitor therapy
Rheumatology (Oxford) 2022 doi: 10.1093/rheumatology/keac285
Real-world population-based study shows that a switch to a second JAKinib results in a higher drug retention, as compared to switching to a TNFi, in patients with RA who discontinue original JAKinib therapy.
Achieving pain control in early rheumatoid arthritis with baricitinib monotherapy or in combination with methotrexate versus methotrexate monotherapy
RMD Open. 2022;8(1):e001994 doi: 10.1136/rmdopen-2021-001994Post hoc analysis of the RA-BEGIN trial finds that, over a one-year period, patients treated with baricitinib (monotherapy or in combination with methotrexate [MTX]) report greater pain relief and a more rapid attainment of clinically meaningful thresholds of pain improvement, than patients who receive MTX monotherapy.Often overlooked, when treating RA solely to a disease activity target, patient-reported pain is common in RA, even in those reaching inflammatory remission. The fact that pain per...
Evaluation of response to 13-valent conjugated pneumococcal vaccination in patients with rheumatoid arthritis receiving upadacitinib: results from a phase 2 open-label extension study
RMD Open. 2022;8(1):e002110 doi: 10.1136/rmdopen-2021-002110Vaccine sub-study of the BALANCE-EXTEND upadacitinib trial finds that approximately two-thirds of patients receiving upadacitinib 15 mg once-daily achieve a satisfactory humoral response to pneumococcal 13-valent conjugate (PCV-13) vaccine, despite receiving concomitant methotrexate (MTX).It is well known that a weakened immune response, comorbidities and immunosuppressant drug therapy all contribute to an increased susceptibility to infections in patients with RA. Likewise, the morbidity and mo...