Relative Remission and Low Disease Activity Rates of Tofacitinib, Baricitinib, Upadacitinib, and Filgotinib versus Methotrexate in Patients with Disease-Modifying Antirheumatic Drug-Naive Rheumatoid Arthritis
Pharmacology 2023 doi 10.1159/000527186 Epub ahead of print
The results of a Bayesian network meta-analysis by Lee and Song showed that JAK inhibitors were more likely to achieve remission and LDA in DMARD-naive RA patients than MTX. However, there were no significant differences in remission rates nor LDA rates between the JAK inhibitors investigated.
Tofacitinib versus Methotrexate as the First-line Disease-modifying Antirheumatic Drugs in the treatment of Rheumatoid Arthritis: An Open-label Randomized Controlled Trial
doi: 10.1111/1756-185X.14801 Epub ahead of print
This single-centre study by Khan, et al. suggests that high-dose methotrexate (25 mg/week, subcutaneously) may be as efficacious as tofacitinib in patients with established RA who are DMARD naïve or have not received a therapeutic dose of DMARDs.
Ann Rheum Dis. 2023;2023-224049 doi: 10.1136/ard-2023-224049 Epub ahead of print
The objective of this study was to estimate the association of JAKi with the incidence of malignancy, compared with placebo, TNFi and MTX.
Evaluation of BMS-986142, a Reversible Bruton’s Tyrosine Kinase Inhibitor, for the Treatment of Rheumatoid Arthritis: A Phase 2, Randomised, Double-blind, Dose-ranging, Placebo-controlled, Adaptive Design Study
Lancet Rheumatol 2023;5:e263–73 doi 10.1016/S2665-9913(23)00089-9
Investigators from a phase 2 study concluded that further investigation with BMS-986142 (a novel BTK) in people with RA is not necessary.
Safety of Guselkumab with and without Prior TNF-α Inhibitor Treatment: Pooled Results Across Four Studies in Patients with Psoriatic Arthritis
J Rheumatol. 2023 jrheum
These results demonstrate that guselkumab was well tolerated in studies continuing for 1 to 2 years among patients with moderate-to-severe PsA regardless of TNFi experience and concomitant MTX use. The objective of this study was to assess pooled safety results from Phase 2/3 studies of guselkumab in TNFi-naïve and experienced PsA patients.
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.