Advances in Axial Spondyloarthritis Treatment: The Role of Janus Kinase Inhibitors DOI Creative Commons

Fatrian Dwicahya,

Cahyo Wibisono Nugroho,

Naufalluthfi Widodo

и другие.

Indian Journal of Rheumatology, Год журнала: 2025, Номер unknown

Опубликована: Май 6, 2025

Axial spondyloarthritis (axSpA) is a chronic inflammatory disease affecting the spine, peripheral joints and entheses, driven by dysregulated immune cell pathways, particularly Janus kinase-signal transducer activator of transcription (JAK‑STAT) pathway. While non‑steroidal anti‑inflammatory drugs biologic disease-modifying anti-rheumatic (DMARDs) (e.g., tumour necrosis factor inhibitors [TNFi] interleukin [IL‑17i]) are standard treatments. However, many patients show inadequate responses, necessitating alternative therapies. JAK (JAKi), including tofacitinib, upadacitinib filgotinib, offer targeted benefits blocking JAK‑STAT pathway to reduce pro-inflammatory cytokine transcription. Clinical trials have demonstrated that tofacitinib significantly improves ankylosing spondylitis outcomes, achieving superior Assessment Spondyloarthritis International Society 20 40 (ASAS20 ASAS40) responses compared placebo. Upadacitinib has consistently shown efficacy across both radiographic non‑radiographic axSpA in SELECT‑AXIS trials, while phase II TORTUGA trial reported filgotinib reduced activity, with greater improvements ASDAS Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores Mild side effects, such as nasopharyngitis increased creatine phosphokinase levels, been observed without conclusive links severe adverse events like malignancies or cardiovascular complications. Thorough screening for tuberculosis viral hepatitis essential before initiating JAKi therapy. Moreover, comorbid bowel disease, where TNFi may be unsuitable, provides an effective alternative. Its oral formulation enhances patient compliance and, combined favourable cost‑effectiveness data, positions attractive alternatives conventional Current evidence suggests promising option unresponsive DMARDs. long-term studies needed compare their safety IL-17i.

Язык: Английский

Incidence of Uveitis and Inflammatory Bowel Disease in Psoriatic Disease, and Psoriatic Disease in Uveitis and Inflammatory Bowel Disease DOI
J. Williams, Uazman Alam, Sizheng Steven Zhao

и другие.

Lara D. Veeken, Год журнала: 2025, Номер unknown

Опубликована: Фев. 20, 2025

Journal Article Accepted manuscript Incidence of Uveitis and Inflammatory Bowel Disease in Psoriatic Disease, Get access Jacob Corum Williams, Williams St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UKLeeds Institute Rheumatic Musculoskeletal Medicine, UK Search for other works by this author on: Oxford Academic PubMed Google Scholar Uazman Alam, Alam Life Course Medical Sciences, Liverpool, UKDepartment Hospital Aintree, Liverpool Foundation Sizheng Steven Zhao Centre Research, Division Dermatological Science, School Biological Faculty Medicine Health, The Manchester, Manchester Health Science Centre, Correspondence to: Dr S Zhao. Road, M13 9LJ, UK. Email: [email protected] Rheumatology, keaf110, https://doi.org/10.1093/rheumatology/keaf110 Published: 20 February 2025 history Received: 14 January Revision received: 30 Accepted: 13

Язык: Английский

Процитировано

0
Incidence and prevalence of hidradenitis suppurativa across spondyloarthritis-related diseases DOI Creative Commons
Sizheng Steven Zhao, Uazman Alam,

Qingfan Yang

и другие.

medRxiv (Cold Spring Harbor Laboratory), Год журнала: 2025, Номер unknown

Опубликована: Март 3, 2025

Abstract Importance Hidradenitis suppurativa (HS) has been associated with spondyloarthritis (SpA) and inflammatory bowel disease (IBD) proposed as a potential manifestation of these conditions. However, the relative rarity HS, combined diverse methodologies used in previous studies, leaves several uncertainties surrounding its epidemiology within this spectrum. Objective To describe prevalence incidence HS across pathologically related diseases family, namely psoriasis, psoriatic arthritis (PsA), axial (axSpA), uveitis, Crohn’s disease, ulcerative colitis. Design Cohort study conducted using data between January 2005 2025. Setting The from electronic health records over 135 million individuals more than 100 healthcare organizations North America. Participants Six populations ranging 46,928 to 191,605 individuals. Exposures Populations PsA, spondyloarthritis, Main outcomes measures Prevalence per 100,000 patient-years HS. Results was 0.4% psoriasis higher axSpA (0.2%), (0.3%) or colitis (0.2%). (124/100,000 patient-years) PsA (119/100,000 other SpA-related (range 69 88/100,000 patient-years), exception (177//100,000 patient-years). Conclusions Relevance This highlights significant epidemiological association diseases, particularly disease. Clinicians providing care patient groups should consider enquiring about symptoms, although overall rates are low. Further research is needed into shared pathophysiology Key points Question What hidradenitis conditions immunopathology such disease? Findings cohort found high among confirmed previously reported Incidence were lower. Meaning for people

Язык: Английский

Процитировано

0
Advances in Axial Spondyloarthritis Treatment: The Role of Janus Kinase Inhibitors DOI Creative Commons

Fatrian Dwicahya,

Cahyo Wibisono Nugroho,

Naufalluthfi Widodo

и другие.

Indian Journal of Rheumatology, Год журнала: 2025, Номер unknown

Опубликована: Май 6, 2025

Axial spondyloarthritis (axSpA) is a chronic inflammatory disease affecting the spine, peripheral joints and entheses, driven by dysregulated immune cell pathways, particularly Janus kinase-signal transducer activator of transcription (JAK‑STAT) pathway. While non‑steroidal anti‑inflammatory drugs biologic disease-modifying anti-rheumatic (DMARDs) (e.g., tumour necrosis factor inhibitors [TNFi] interleukin [IL‑17i]) are standard treatments. However, many patients show inadequate responses, necessitating alternative therapies. JAK (JAKi), including tofacitinib, upadacitinib filgotinib, offer targeted benefits blocking JAK‑STAT pathway to reduce pro-inflammatory cytokine transcription. Clinical trials have demonstrated that tofacitinib significantly improves ankylosing spondylitis outcomes, achieving superior Assessment Spondyloarthritis International Society 20 40 (ASAS20 ASAS40) responses compared placebo. Upadacitinib has consistently shown efficacy across both radiographic non‑radiographic axSpA in SELECT‑AXIS trials, while phase II TORTUGA trial reported filgotinib reduced activity, with greater improvements ASDAS Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) scores Mild side effects, such as nasopharyngitis increased creatine phosphokinase levels, been observed without conclusive links severe adverse events like malignancies or cardiovascular complications. Thorough screening for tuberculosis viral hepatitis essential before initiating JAKi therapy. Moreover, comorbid bowel disease, where TNFi may be unsuitable, provides an effective alternative. Its oral formulation enhances patient compliance and, combined favourable cost‑effectiveness data, positions attractive alternatives conventional Current evidence suggests promising option unresponsive DMARDs. long-term studies needed compare their safety IL-17i.

Язык: Английский

Процитировано

0