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.
Risk of Major Adverse Cardiovascular Events in Patients with Rheumatoid Arthritis Treated with Conventional Synthetic, Biologic and Targeted Synthetic Disease-modifying Antirheumatic Drugs: Observational Data from the German RABBIT Register
This study by Meissner, et al. estimated the effects of JAKi, TNFi, bDMARDs and csDMARDs on the risk of MACE in RA patients. The authors found no significant difference in MACE risk by treatment group, even among patients at increased CV risk.
Therapy with JAK Inhibitors or bDMARDs and the Risk of Cardiovascular Events in the Dutch Rheumatoid Arthritis Population
Rheumatology (Oxford) 2023 doi 10.1093/rheumatology/kead531 Epub ahead of print
Popa, et al. compared the incidence of CV events between JAKi and bDMARD therapies in a large RA population, and found no significant difference in CV risk between the treatment groups. They also compared CV risk between baricitinib-treated and tofacitinib-treated patients and found no significant difference.
Janus Kinase Inhibitor—Tofacitinib Associated with Pemphigus: An Analysis of the FDA Adverse Event Reporting System Data
Expert Opin Drug Saf. 2023;18:1-4 doi: 10.1080/14740338.2023.2248872 Epub ahead of print
This study presents initial data suggesting an association between the use of JAK inhibitors and pemphigus. This research used the FAERS database to investigate connections between JAK inhibitor usage and the occurrence of pemphigus as an adverse event.
A Real-World Effectiveness Study Using a Mobile Application to Evaluate Early Outcomes with Upadacitinib in Rheumatoid Arthritis
Rheumatol Ther. 2023 doi 10.1007/s40744-023-00594-6 Epub ahead of print
This study by Harrold, et al. showed that RA patients initiating upadacitinib reported improvements in RAPID3, pain, stiffness, and fatigue as early as Week 1, with 37.5% achieving RAPID3 LDA at Week 12. TNFi-experienced patients had similar outcomes.
Differential Properties of Janus Kinase Inhibitors in the Treatment of Immune-mediated Inflammatory Diseases
Rheumatology (Oxford) 2023 doi 10.1093/rheumatology/kead448 Epub ahead of print
JAKis differ in structure, which affects their inhibitory concentration for different JAKs.
This review by Taylor, et al. compares the pharmacological profiles of JAKis, including abrocitinib, baricitinib, filgotinib, peficitinib, tofacitinib, and upadacitinib.
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.
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.
Efficacy and Safety of the TYK2/JAK1 Inhibitor Brepocitinib for Active Psoriatic Arthritis: A Phase IIb Randomized Controlled Trial
Arthritis Rheumatol. 2023;75(8):1370–1380 doi: 10.1002/art.42519
Phase IIb study of brepocitinib in patients with PsA concludes that treatment with brepocitinib 30 mg and 60 mg QD, was superior to placebo at reducing signs and symptoms of PsA and was well-tolerated over 52 weeks.
Filgotinib Modulates Inflammation-Associated Peripheral Blood Protein Biomarkers in Adults with Active Rheumatoid Arthritis and Prior Inadequate Response to Methotrexate
Rheumatol Ther. 2023 doi 10.1007/s40744-023-00583-9 Epub ahead of print
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.