Clinical Edge Journal Scan

JAKi effective for PsA but higher doses may have increased toxicity


 

Key clinical point: All Janus kinase inhibitors (JAKi) were more effective than placebo in patients with psoriatic arthritis (PsA), but led to a higher overall incidence of adverse events, particularly at higher doses.

Major finding: JAKi vs placebo were associated with a significantly higher American College of Rheumatology 20 response rate (relative risk [RR] 2.09; P < .00001), with the response being the highest for filgotinib (RR 2.40; P < .00001), followed by upadacitinib, tofacitinib, and deucravacitinib. However, the overall incidence of adverse events was higher with JAKi vs placebo (RR 1.17; P < .00001) and significantly higher with 10 mg vs 5 mg tofacitinib ( P = .03).

Study details: The data come from a systematic review and meta-analysis of 17 phase 2/3 randomized controlled trials including 6802 patients with PsA or moderate-to-severe plaque psoriasis who received 1 JAKi.

Disclosures: This study was supported by the National Basic Research Program of China. The authors declared no conflicts of interest.

Source: Yang F et al. Efficacy and safety of Janus kinase inhibitors in patients with psoriasis and psoriatic arthritis: A systematic review and meta analysis. Clin Rheumatol . 2023 (Feb 10). Doi: 10.1007/s10067-023-06529-4

Recommended Reading

What’s holding back physicians from prescribing biosimilars? Four specialties weigh in
MDedge Rheumatology
Treating nail psoriasis: Intralesional injections and biologics
MDedge Rheumatology
Isolated nail psoriasis may bring arthritis into play
MDedge Rheumatology
Commentary: Concerning PsA treatments and comorbidities, March 2023
MDedge Rheumatology
Biologics show signs of delaying arthritis in psoriasis patients
MDedge Rheumatology
Psoriatic arthritis treatment for women falls short, study suggests
MDedge Rheumatology
Gender-based differences in treatment outcomes and persistence with ustekinumab or TNFi in PsA
MDedge Rheumatology
Achievement of low disease activity improves long-term structural damage in PsA
MDedge Rheumatology
Active disease in third trimester increases risk for emergency caesarean section in PsA
MDedge Rheumatology
Guselkumab resolves dactylitis and improves clinical outcomes in patients with active PsA
MDedge Rheumatology