Safety of Janus kinase inhibitors in rheumatoid arthritis: a disproportionality analysis using FAERS database from 2012 to 2022

Clinical Rheumatology, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 13, 2025

Abstract Introduction/objective Janus kinase (JAK) inhibitors have expanded treatment options for rheumatoid arthritis (RA), particularly patients unresponsive to traditional disease-modifying antirheumatic drugs (DMARDs). However, safety concerns necessitate a thorough post-market evaluation. This study is aimed at comparing the profiles of tofacitinib, baricitinib, and upadacitinib using adverse event (AE) reports from FDA Adverse Event Reporting System (FAERS). Methods A retrospective disproportionality analysis was performed FAERS data 2012 2022. The AE were categorized into cardiovascular, cancer, respiratory, gastrointestinal, musculoskeletal, arthralgia-related events. Proportional reporting ratio (PRR) odds ratios (RORs) with 95% confidence intervals (CIs) calculated identify significant signals. Results Of 273,657 reports, tofacitinib had most (227,144), increased musculoskeletal-related events (ROR = 1.53, CI 1.49–1.57) reduced cancer risk 0.44, 0.41–0.47). Baricitinib (9305 reports) showed highest cardiovascular 1.63, 1.50–1.78) 2.17, 1.83–2.58). Upadacitinib (37,208 elevated risks respiratory 2.04, 1.88–2.21) 2.24, 2.05–2.43). Conclusion distinct these JAK suggest that baricitinib poses higher risks, whereas increases gastrointestinal Tofacitinib may be safer history but requires monitoring musculoskeletal AEs. Personalized assessments are critical safe use inhibitors. Key Points • provides comprehensive assessment three inhibitors—tofacitinib, upadacitinib—using Distinct identified, showing while posed an demonstrated lower than other associated more These findings emphasize importance personalized vigilant when prescribing arthritis.

Language: Английский

Therapeutic Advancements in Psoriasis and Psoriatic Arthritis

Journal of Clinical Medicine, Journal Year: 2025, Volume and Issue: 14(4), P. 1312 - 1312

Published: Feb. 16, 2025

Background: Within the past few years, many new therapies have emerged for psoriasis and psoriatic arthritis (PsA). Current topical therapies-including corticosteroids, vitamin D analogs, tapinarof, roflumilast-remain mainstay mild disease, while oral systemic biologic options are moderate to severe cases. Biologics-such as Tumor necrosis factor-alpha (TNF-alpha), Interleukin 12/23 (IL-12/23), Interleukin-17 (IL-17), Interleukin-23 (IL-23)-have revolutionized care by providing highly effective safer alternatives. Oral small molecules, including Janus kinase (JAK) tyrosine 2 (TYK2) inhibitors, further expand therapeutic options. Objectives: The goal this review article was examine current latest treatments PsA discuss whether these emerging address unmet needs of treatments. Methods: search included PubMed, Google Scholar, ClinicalTrials.gov relevant articles clinical trials using keywords. Results: A wide range novel currently undergoing trials. These include selective JAK TYK2 retinoic acid-related orphan receptor (RORγT) IL-23 IL-17A nanobody products, sphingosine-1-phosphate (S1P1R) antagonists, A3 adenosine (A3AR) agonists, heat shock protein (HSP) 90 rho-associated kinases (ROCK-2) inhibitors. Conclusions: different mechanisms action not only treatment but may offer potential solutions patients who do achieve adequate response with existing therapies. However, safety contraindications newer agents remain an important consideration ensure appropriate patient selection minimize risks. Certain pose increased risks infection, cardiovascular manifestations, malignancy, or other immune-related adverse events, necessitating careful monitoring individualized decisions. Ongoing research aims respond previous sustained remission, monitor long-term outcomes, assess preferences delivery, a preference delivery. inhibitors hold due their robust profiles. In contrast, IL-17 TYK-2 present side effects that could impact acceptability. It is essential balance efficacy, safety, guide

Language: Английский

Theory & practice of Treat-to-Target (T2T) in rheumatoid arthritis

Best Practice & Research Clinical Rheumatology, Journal Year: 2024, Volume and Issue: unknown, P. 102018 - 102018

Published: Nov. 1, 2024

Language: Английский