AxSpA Literature Highlights – February 2023
Bimekizumab, Secukinumab, TNF Inhibitor, bDMARD, Achilles Enthesitis
View and download slide summaries of the latest original articles focusing on cytokine signalling therapies within rheumatoid arthritis. All materials produced by the CSF team are subsequently reviewed and approved by individual Steering Committee members.
Bimekizumab, Secukinumab, TNF Inhibitor, bDMARD, Achilles Enthesitis
Ann Rheum Dis. 2023 Jan 17 doi: 10.1136/ard-2022-223595
Bimekizumab may therefore offer patients with axSpA an effective treatment option with a novel mode of action.
Ann Rheum Dis 2022; online ahead of print doi:10.1136/ard-2022-223296
Since the last update in 2016, more data have become available on existing treatment options for axSpA, and particularly on IL-17i. The increasing availability of more drugs and with different modes of action raises questions around their positioning in the treatment pathway. This review sought to update the 2016 recommendations with newly available evidence.
Rheumatology (Oxford). 2022 doi: 10.1093/rheumatology/keac605
This study reported the long-term efficacy, safety, and tolerability of RZB through 52 weeks of treatment in KEEPsAKE 2. In doing so it demonstrated long-term, durable efficacy of risankizumab in improving symptom control, physical function and quality of life in patients with active PsA who were csDMARD-IR or Bio-IR.
Ann Rheum Dis. 2022 doi: 10.1136/ard-2022-222731
The present analysis demonstrated that patients continuously treated with IXE were less likely to experience flare compared with patients receiving placebo. The aim of this study was to evaluate the recapture of response with open-label IXE retreatment at week 104 in patients with axSpA who flared after withdrawal of IXE therapy.
Lancet 2022 doi: 10.1016/S0140-6736(22)01212-0
Upadacitinib significantly improved the signs and symptoms of nr-axSpA compared with placebo at Week 14 in this investigation. Prior to this, upadacitinib had been shown to be effective in patients with AS. This study aimed to assess the efficacy and safety of upadacitinib in non-radiographic axial spondyloarthritis.
RMD Open 2022 doi:10.1136/rmdopen-2022-002253
Navarro-Compán et al, determined the effectiveness of tofacitinib in patients with active ankylosing spondylitis in a Phase III, randomised, double-blind, placebo-controlled trial.
Rheumatol Ther. 2021;8(2):903–919
Fifty-six-week data suggest that upadacitinib could be a favourable long-term treatment option in patients with PsA who are refractory to biologic therapy.As the need for additional therapeutic agents that can effectively control disease activity continues, new data from a 56-week analysis of the oral reversible JAK1 inhibitor, upadacitinib, currently under investigation for the treatment of PsA, shows that efficacy of the drug is maintained over the duration of this study.Mease, et al. explored...Annals of the rheumatic diseases. 2021 Mar 1;80(3):312-20.
In this trial of patients with active PsA who had inadequate response or intolerance to at least one biologic DMARD, upadacitinib 15 mg and 30 mg was more effective than placebo over 24 weeks in improving signs and symptoms of PsA. Despite the availability of bDMARDs in PsA, only a small proportion of patients achieve the recommended target of minimal disease activity; as such, additional treatment options are needed. Upadacitinib is under evaluation for PsA. This paper reports the 24-week data ...Ann Rheum Dis 2020; doi:10.1136/annrheumdis-2020-21841220
Both ACR and EULAR recommend adding a biologic or targeted synthetic DMARD in patients who do not achieve treatment goals at follow-up. Findings indicated that an immediate switch in mechanism of action (from JAKi to TNFi and vice versa) following treat-to-target principles is feasible with minimal risk of flare regardless of whether patients are switched due to non-response or incomplete-response.SELECT-COMPARE followed treat-to-target principles to examine the efficacy of switching in two pati...Lancet. 2018 Dec 1;392(10162):2367-2377. DOI 10.1016/ S0140-6736(18)32483-8
In this first clinical trial of filgotinib in patients with PsA, filgotinib was effective in treating the signs and symptoms of active PsA across various disease manifestations.The EQUATOR trial was a randomized, double-blind, placebo-controlled, Phase 2 trial, that enrolled 191 adult patients from 25 sites in seven countries. Patients with active moderate-to-severe PsA and an insufficient response or intolerance to at least one csDMARD were assigned 1:1 to receive filgotinib 200 mg or placebo o...