Switch to subcutaneous methotrexate curbs RA disease activity and increases quality of life

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Key clinical point: RA patients who switched from oral to subcutaneous methotrexate reported an increased quality of life and reduced symptoms.

Major finding: The proportion of RA patients with symptom remission or low disease activity increased from 22.8% to 52.9% after changing from oral to subcutaneous delivery of methotrexate, combined with a dose increase in 34.8% of patients.

Study details: The data come from a prospective, observational study of 207 adults with RA who switched from oral to subcutaneous methotrexate; 6.7% were in remission and 15.5% had low disease activity at baseline.

Disclosures: The study was supported by NORDIC Pharma. Several study coauthors disclosed relationships with NORDIC Pharma, and several are employees of NORDIC Pharma.

Source: Senbel E et al. Patient Prefer Adherence. 2021 Apr 14. doi: 10.2147/PPA.S301010.

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Key clinical point: RA patients who switched from oral to subcutaneous methotrexate reported an increased quality of life and reduced symptoms.

Major finding: The proportion of RA patients with symptom remission or low disease activity increased from 22.8% to 52.9% after changing from oral to subcutaneous delivery of methotrexate, combined with a dose increase in 34.8% of patients.

Study details: The data come from a prospective, observational study of 207 adults with RA who switched from oral to subcutaneous methotrexate; 6.7% were in remission and 15.5% had low disease activity at baseline.

Disclosures: The study was supported by NORDIC Pharma. Several study coauthors disclosed relationships with NORDIC Pharma, and several are employees of NORDIC Pharma.

Source: Senbel E et al. Patient Prefer Adherence. 2021 Apr 14. doi: 10.2147/PPA.S301010.

Key clinical point: RA patients who switched from oral to subcutaneous methotrexate reported an increased quality of life and reduced symptoms.

Major finding: The proportion of RA patients with symptom remission or low disease activity increased from 22.8% to 52.9% after changing from oral to subcutaneous delivery of methotrexate, combined with a dose increase in 34.8% of patients.

Study details: The data come from a prospective, observational study of 207 adults with RA who switched from oral to subcutaneous methotrexate; 6.7% were in remission and 15.5% had low disease activity at baseline.

Disclosures: The study was supported by NORDIC Pharma. Several study coauthors disclosed relationships with NORDIC Pharma, and several are employees of NORDIC Pharma.

Source: Senbel E et al. Patient Prefer Adherence. 2021 Apr 14. doi: 10.2147/PPA.S301010.

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Mast cells may impact joint destruction through gene expression

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Key clinical point: Stimulation with IL-33 showed an increase in several mast cell lines in RA patients compared to controls, suggesting that inhibiting mast cells might be a therapeutic strategy to prevent joint deterioration in RA patients.

Major finding: Synovial tissues in RA patients showed more more c-kit- and FcεRI-positive mast cells, which are producers of both tryptase and chymase, compared to controls after stimulation with IL-33. In addition, IL-33-stimulated mast cells promoted more osteoclast differentiation than non-stimulated mast cells.

Study details: The data come from synovial fluid samples collected from 20 RA patients and 20 patients with osteoarthritis of knee joints who served as controls. 

Disclosures: The study was supported in part by grants from the National Research Foundation of Korea. The researchers had no financial conflicts to disclose.  

Source: Kim K-W et al. Arthritis Res Ther. 2021 Apr 21. doi: 10.1186/s13075-021-02491-1.

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Key clinical point: Stimulation with IL-33 showed an increase in several mast cell lines in RA patients compared to controls, suggesting that inhibiting mast cells might be a therapeutic strategy to prevent joint deterioration in RA patients.

Major finding: Synovial tissues in RA patients showed more more c-kit- and FcεRI-positive mast cells, which are producers of both tryptase and chymase, compared to controls after stimulation with IL-33. In addition, IL-33-stimulated mast cells promoted more osteoclast differentiation than non-stimulated mast cells.

Study details: The data come from synovial fluid samples collected from 20 RA patients and 20 patients with osteoarthritis of knee joints who served as controls. 

Disclosures: The study was supported in part by grants from the National Research Foundation of Korea. The researchers had no financial conflicts to disclose.  

Source: Kim K-W et al. Arthritis Res Ther. 2021 Apr 21. doi: 10.1186/s13075-021-02491-1.

Key clinical point: Stimulation with IL-33 showed an increase in several mast cell lines in RA patients compared to controls, suggesting that inhibiting mast cells might be a therapeutic strategy to prevent joint deterioration in RA patients.

Major finding: Synovial tissues in RA patients showed more more c-kit- and FcεRI-positive mast cells, which are producers of both tryptase and chymase, compared to controls after stimulation with IL-33. In addition, IL-33-stimulated mast cells promoted more osteoclast differentiation than non-stimulated mast cells.

Study details: The data come from synovial fluid samples collected from 20 RA patients and 20 patients with osteoarthritis of knee joints who served as controls. 

Disclosures: The study was supported in part by grants from the National Research Foundation of Korea. The researchers had no financial conflicts to disclose.  

Source: Kim K-W et al. Arthritis Res Ther. 2021 Apr 21. doi: 10.1186/s13075-021-02491-1.

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MicroRNA expression differs in methotrexate-treated RA patients

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Key clinical point: In an analysis of blood-derived CD19+ B cells, miRNAs may have regulatory functions in RA patients treated with methotrexate.

Major finding: Differences in expression were noted for 27 microRNAs between methotrexate patients and controls, but no significant differences between newly diagnosed patients and controls. Some of the differentially expressed miRNAs were dysregulated in RA patients including miR-223-3p, miR-486-3p and miR-23a-3p. 

Study details: The data come from small RNA sequencing of 10 newly diagnosed untreated RA patients (n=10), 18 successfully methotrexate (MTX) treated RA patients in remission, and 9 healthy controls.

Disclosures: The study was supported in part by Helse Sør-Øst Grants. The researchers had no financial conflicts to disclose.

Source: Heinicke F et al. Front Immunol. 2021 Apr 9. doi: 10.3389/fimmu.2021.663736.

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Key clinical point: In an analysis of blood-derived CD19+ B cells, miRNAs may have regulatory functions in RA patients treated with methotrexate.

Major finding: Differences in expression were noted for 27 microRNAs between methotrexate patients and controls, but no significant differences between newly diagnosed patients and controls. Some of the differentially expressed miRNAs were dysregulated in RA patients including miR-223-3p, miR-486-3p and miR-23a-3p. 

Study details: The data come from small RNA sequencing of 10 newly diagnosed untreated RA patients (n=10), 18 successfully methotrexate (MTX) treated RA patients in remission, and 9 healthy controls.

Disclosures: The study was supported in part by Helse Sør-Øst Grants. The researchers had no financial conflicts to disclose.

Source: Heinicke F et al. Front Immunol. 2021 Apr 9. doi: 10.3389/fimmu.2021.663736.

Key clinical point: In an analysis of blood-derived CD19+ B cells, miRNAs may have regulatory functions in RA patients treated with methotrexate.

Major finding: Differences in expression were noted for 27 microRNAs between methotrexate patients and controls, but no significant differences between newly diagnosed patients and controls. Some of the differentially expressed miRNAs were dysregulated in RA patients including miR-223-3p, miR-486-3p and miR-23a-3p. 

Study details: The data come from small RNA sequencing of 10 newly diagnosed untreated RA patients (n=10), 18 successfully methotrexate (MTX) treated RA patients in remission, and 9 healthy controls.

Disclosures: The study was supported in part by Helse Sør-Øst Grants. The researchers had no financial conflicts to disclose.

Source: Heinicke F et al. Front Immunol. 2021 Apr 9. doi: 10.3389/fimmu.2021.663736.

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JAKi and methotrexate combination shows no increased malignancy risk in RA

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Key clinical point: Rheumatoid arthritis patients taking a combination of methotrexate and JAKi showed no increased risk of malignancy compared to RA patients on methotrexate alone.

Major finding: No significant differences in overall malignancy appeared between methotrexate /JAKi combination patients compared to methotrexate-only patients (risk ratio 1.42); no differences appeared between the groups for nonmelanoma skin cancer (RR 1.44), malignancies excluding nonmelanoma skin cancer (RR 1.12), serious adverse events (RR 1.15), or deaths (RR 1.99).

Study details: The data come from a meta-analysis of 13 randomized, controlled trials with a total of 6,911 RA patients who received methotrexate and Janus kinase inhibitors (JAKi) 

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Solipuram V et al. Auto Immune Highlights. 2021 Apr 28. doi: 10.1186/s13317-021-00153-5.

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Key clinical point: Rheumatoid arthritis patients taking a combination of methotrexate and JAKi showed no increased risk of malignancy compared to RA patients on methotrexate alone.

Major finding: No significant differences in overall malignancy appeared between methotrexate /JAKi combination patients compared to methotrexate-only patients (risk ratio 1.42); no differences appeared between the groups for nonmelanoma skin cancer (RR 1.44), malignancies excluding nonmelanoma skin cancer (RR 1.12), serious adverse events (RR 1.15), or deaths (RR 1.99).

Study details: The data come from a meta-analysis of 13 randomized, controlled trials with a total of 6,911 RA patients who received methotrexate and Janus kinase inhibitors (JAKi) 

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Solipuram V et al. Auto Immune Highlights. 2021 Apr 28. doi: 10.1186/s13317-021-00153-5.

Key clinical point: Rheumatoid arthritis patients taking a combination of methotrexate and JAKi showed no increased risk of malignancy compared to RA patients on methotrexate alone.

Major finding: No significant differences in overall malignancy appeared between methotrexate /JAKi combination patients compared to methotrexate-only patients (risk ratio 1.42); no differences appeared between the groups for nonmelanoma skin cancer (RR 1.44), malignancies excluding nonmelanoma skin cancer (RR 1.12), serious adverse events (RR 1.15), or deaths (RR 1.99).

Study details: The data come from a meta-analysis of 13 randomized, controlled trials with a total of 6,911 RA patients who received methotrexate and Janus kinase inhibitors (JAKi) 

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Solipuram V et al. Auto Immune Highlights. 2021 Apr 28. doi: 10.1186/s13317-021-00153-5.

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Methotrexate treatment for RA falls short with smokers

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Key clinical point: Current smoking was an independent predictor of inadequate response to methotrexate in treatment-naïve rheumatoid arthritis patients.

Major finding: Inadequate response to methotrexate, demonstrated by failure to achieve low disease activity, was significantly associated with current smoking (adjusted odds ratio 1.79). Lack of EULAR response also was significantly associated with current smoking (aOR 2.04).

Study details: The data come from a retrospective cohort study of 294 rheumatoid arthritis patients (60.5% women) who were naïve to disease modifying anti-rheumatic drugs.  

Disclosures: The study was supported by an unconditioned research grant from Pfizer. The researchers had no financial conflicts to disclose.

Source: Floris A et al. Medicine. 2021 Apr 30. doi: 10.1097/MD.0000000000025481.

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Key clinical point: Current smoking was an independent predictor of inadequate response to methotrexate in treatment-naïve rheumatoid arthritis patients.

Major finding: Inadequate response to methotrexate, demonstrated by failure to achieve low disease activity, was significantly associated with current smoking (adjusted odds ratio 1.79). Lack of EULAR response also was significantly associated with current smoking (aOR 2.04).

Study details: The data come from a retrospective cohort study of 294 rheumatoid arthritis patients (60.5% women) who were naïve to disease modifying anti-rheumatic drugs.  

Disclosures: The study was supported by an unconditioned research grant from Pfizer. The researchers had no financial conflicts to disclose.

Source: Floris A et al. Medicine. 2021 Apr 30. doi: 10.1097/MD.0000000000025481.

Key clinical point: Current smoking was an independent predictor of inadequate response to methotrexate in treatment-naïve rheumatoid arthritis patients.

Major finding: Inadequate response to methotrexate, demonstrated by failure to achieve low disease activity, was significantly associated with current smoking (adjusted odds ratio 1.79). Lack of EULAR response also was significantly associated with current smoking (aOR 2.04).

Study details: The data come from a retrospective cohort study of 294 rheumatoid arthritis patients (60.5% women) who were naïve to disease modifying anti-rheumatic drugs.  

Disclosures: The study was supported by an unconditioned research grant from Pfizer. The researchers had no financial conflicts to disclose.

Source: Floris A et al. Medicine. 2021 Apr 30. doi: 10.1097/MD.0000000000025481.

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Delayed diagnosis raises mortality risk for RA patients with lung disease

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Key clinical point: Diagnostic delay was an independent predictor of mortality in RA patients with interstitial lung disease in a multivariate analysis.

Major finding: Diagnostic delay was significantly associated with increased risk of mortality in adults with RA and interstitial lung disease (hazard ratio 1.11), along with age, severe oxygen desaturation on effort (SatO2) and diffusion capacity for carbon monoxide (DLCO); with hazard ratios of 1.33, 0.85, and 0.62, respectively.   

Study details: The data come from a multicenter study of 106 consecutive adults with rheumatoid arthritis and interstitial lung disease.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Cano-Jiménez E et al. Sci Rep. 2021 Apr 28. doi: 10.1038/s41598-021-88734-2.

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Key clinical point: Diagnostic delay was an independent predictor of mortality in RA patients with interstitial lung disease in a multivariate analysis.

Major finding: Diagnostic delay was significantly associated with increased risk of mortality in adults with RA and interstitial lung disease (hazard ratio 1.11), along with age, severe oxygen desaturation on effort (SatO2) and diffusion capacity for carbon monoxide (DLCO); with hazard ratios of 1.33, 0.85, and 0.62, respectively.   

Study details: The data come from a multicenter study of 106 consecutive adults with rheumatoid arthritis and interstitial lung disease.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Cano-Jiménez E et al. Sci Rep. 2021 Apr 28. doi: 10.1038/s41598-021-88734-2.

Key clinical point: Diagnostic delay was an independent predictor of mortality in RA patients with interstitial lung disease in a multivariate analysis.

Major finding: Diagnostic delay was significantly associated with increased risk of mortality in adults with RA and interstitial lung disease (hazard ratio 1.11), along with age, severe oxygen desaturation on effort (SatO2) and diffusion capacity for carbon monoxide (DLCO); with hazard ratios of 1.33, 0.85, and 0.62, respectively.   

Study details: The data come from a multicenter study of 106 consecutive adults with rheumatoid arthritis and interstitial lung disease.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Cano-Jiménez E et al. Sci Rep. 2021 Apr 28. doi: 10.1038/s41598-021-88734-2.

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Watch for rheumatic immune-related adverse events in ICI patients

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Key clinical point: Rheumatic immune-related adverse events occurred in approximately one-third of cancer patients on immune checkpoint inhibitor (ICI) therapy.

Major finding: A total of 37.3% of patients on ICI therapy experienced at least one immune-related adverse event; 4.3% of patients experienced at least one rheumatic immune-related adverse event (rh-irAEs) and 3 of these patients had pre-existing rheumatic disease.

Study details: The data come from 437 adult cancer patients who were treated with ipilimumab and/or nivolumab, or pembrolizumab at a single center between January 2014 and December 2018.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Verspohl SH et al. Ther Adv Musculoskelet Dis. 2021 Apr 12. doi: 10.1177/1759720X211006963.

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Key clinical point: Rheumatic immune-related adverse events occurred in approximately one-third of cancer patients on immune checkpoint inhibitor (ICI) therapy.

Major finding: A total of 37.3% of patients on ICI therapy experienced at least one immune-related adverse event; 4.3% of patients experienced at least one rheumatic immune-related adverse event (rh-irAEs) and 3 of these patients had pre-existing rheumatic disease.

Study details: The data come from 437 adult cancer patients who were treated with ipilimumab and/or nivolumab, or pembrolizumab at a single center between January 2014 and December 2018.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Verspohl SH et al. Ther Adv Musculoskelet Dis. 2021 Apr 12. doi: 10.1177/1759720X211006963.

Key clinical point: Rheumatic immune-related adverse events occurred in approximately one-third of cancer patients on immune checkpoint inhibitor (ICI) therapy.

Major finding: A total of 37.3% of patients on ICI therapy experienced at least one immune-related adverse event; 4.3% of patients experienced at least one rheumatic immune-related adverse event (rh-irAEs) and 3 of these patients had pre-existing rheumatic disease.

Study details: The data come from 437 adult cancer patients who were treated with ipilimumab and/or nivolumab, or pembrolizumab at a single center between January 2014 and December 2018.

Disclosures: The study received no outside funding. The researchers had no financial conflicts to disclose.

Source: Verspohl SH et al. Ther Adv Musculoskelet Dis. 2021 Apr 12. doi: 10.1177/1759720X211006963.

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Internet intervention eases anxiety in rheumatoid arthritis patients

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Key clinical point: The Internet-based Worry and Sadness program improved mental health in adults with rheumatoid arthritis over 3 months.

Major finding: At 3 months’ follow-up, measures of anxiety, depression, and emotional distress  improved significantly from baseline with effect sizes ranging from small to large; 44% of participants had normal scores for anxiety (medium effect size).

Study details: The data come from 28 adults (mean age 57 years, 86% women) with rheumatoid arthritis who completed an Internet-based cognitive-behavioral therapy intervention.

Disclosures: The study was supported in part by a University of Manitoba Graduate Fellowship and The Arthritis Society 2016 PhD Salary Award to lead author Dr. Blaney, and by the CIHR Chronic Pain SPOR Network and Health Sciences Centre. The researchers had no financial conflicts to disclose.

Source: Blaney C et al. Internet Interv. 2021 Mar 26. doi: 10.1016/j.invent.2021.100385.

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Key clinical point: The Internet-based Worry and Sadness program improved mental health in adults with rheumatoid arthritis over 3 months.

Major finding: At 3 months’ follow-up, measures of anxiety, depression, and emotional distress  improved significantly from baseline with effect sizes ranging from small to large; 44% of participants had normal scores for anxiety (medium effect size).

Study details: The data come from 28 adults (mean age 57 years, 86% women) with rheumatoid arthritis who completed an Internet-based cognitive-behavioral therapy intervention.

Disclosures: The study was supported in part by a University of Manitoba Graduate Fellowship and The Arthritis Society 2016 PhD Salary Award to lead author Dr. Blaney, and by the CIHR Chronic Pain SPOR Network and Health Sciences Centre. The researchers had no financial conflicts to disclose.

Source: Blaney C et al. Internet Interv. 2021 Mar 26. doi: 10.1016/j.invent.2021.100385.

Key clinical point: The Internet-based Worry and Sadness program improved mental health in adults with rheumatoid arthritis over 3 months.

Major finding: At 3 months’ follow-up, measures of anxiety, depression, and emotional distress  improved significantly from baseline with effect sizes ranging from small to large; 44% of participants had normal scores for anxiety (medium effect size).

Study details: The data come from 28 adults (mean age 57 years, 86% women) with rheumatoid arthritis who completed an Internet-based cognitive-behavioral therapy intervention.

Disclosures: The study was supported in part by a University of Manitoba Graduate Fellowship and The Arthritis Society 2016 PhD Salary Award to lead author Dr. Blaney, and by the CIHR Chronic Pain SPOR Network and Health Sciences Centre. The researchers had no financial conflicts to disclose.

Source: Blaney C et al. Internet Interv. 2021 Mar 26. doi: 10.1016/j.invent.2021.100385.

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Beta blocker use reduced remission in rheumatoid arthritis

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Key clinical point: Use of beta blockers was significantly associated with remission in RA based on the Simplified Disease Activity Index and Clinical Disease Activity Index.

Major finding: Approximately 11% of the RA patients were using systemic beta blockers, and beta blocker use was associated with less frequent remission, both in the total study cohort and the cohort of patients with cardiovascular disease (adjusted hazard ratios 0.70 and 0.75, respectively).

Study details: The data come from a pooled cohort analysis of five randomized trials of tocilizumab and/or csDMARDs including 5,502 RA patients.

Disclosures: The study received no outside funding. Two researchers were supported by Beat Cancer Research Fellowships from Cancer Council South Australia and a Postdoctoral Fellowship from the National Breast Cancer Foundation, Australia. The lead author and other researchers had no financial conflicts to disclose. 

Source: Abuhelwa AY. Ther Adv Musculoskelet Dis. 2021 Apr 12. doi: 10.1177/1759720X211009020.

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Key clinical point: Use of beta blockers was significantly associated with remission in RA based on the Simplified Disease Activity Index and Clinical Disease Activity Index.

Major finding: Approximately 11% of the RA patients were using systemic beta blockers, and beta blocker use was associated with less frequent remission, both in the total study cohort and the cohort of patients with cardiovascular disease (adjusted hazard ratios 0.70 and 0.75, respectively).

Study details: The data come from a pooled cohort analysis of five randomized trials of tocilizumab and/or csDMARDs including 5,502 RA patients.

Disclosures: The study received no outside funding. Two researchers were supported by Beat Cancer Research Fellowships from Cancer Council South Australia and a Postdoctoral Fellowship from the National Breast Cancer Foundation, Australia. The lead author and other researchers had no financial conflicts to disclose. 

Source: Abuhelwa AY. Ther Adv Musculoskelet Dis. 2021 Apr 12. doi: 10.1177/1759720X211009020.

Key clinical point: Use of beta blockers was significantly associated with remission in RA based on the Simplified Disease Activity Index and Clinical Disease Activity Index.

Major finding: Approximately 11% of the RA patients were using systemic beta blockers, and beta blocker use was associated with less frequent remission, both in the total study cohort and the cohort of patients with cardiovascular disease (adjusted hazard ratios 0.70 and 0.75, respectively).

Study details: The data come from a pooled cohort analysis of five randomized trials of tocilizumab and/or csDMARDs including 5,502 RA patients.

Disclosures: The study received no outside funding. Two researchers were supported by Beat Cancer Research Fellowships from Cancer Council South Australia and a Postdoctoral Fellowship from the National Breast Cancer Foundation, Australia. The lead author and other researchers had no financial conflicts to disclose. 

Source: Abuhelwa AY. Ther Adv Musculoskelet Dis. 2021 Apr 12. doi: 10.1177/1759720X211009020.

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JAK inhibitors may hinder DNA damage response

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Key clinical point: Treatment of irradiated peripheral blood mononuclear cells (PBMCs) with filgotinib in particular correlated with enhanced foci in vitro; the study was a rare comparison of all four JAKis approved for RA: tofacitinib, baricitinib, and upadacitinib, and filgotinib.

Major finding: Lymphocyte proliferation was similar for tofacitinib, baricitinib, and upadacitinib, while dosage of filgotinib was two orders of magnitude higher when these JAKis were added to peripheral blood mononuclear cells from healthy donors.

Study details: The data come from an in vitro study of four JAK inhibitors currently approved for the treatment of RA: tofacitinib, baricitinib, upadacitinib, and filgotinib, in which increasing concentrations of the JAKis or methotrexate were added to peripheral blood mononuclear cells from healthy volunteers.

Disclosures: The study was supported by the European Union Program Regional Development Fund of the Ministry of Economy, Science and Digitalisation in Saxony-Anhalt. Lead author Dr. Reddig had no financial conflicts to disclose.

Source: Reddig A et al. J Clin Med. 2021 Apr 1. doi: 103390/jcm10071431.

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Key clinical point: Treatment of irradiated peripheral blood mononuclear cells (PBMCs) with filgotinib in particular correlated with enhanced foci in vitro; the study was a rare comparison of all four JAKis approved for RA: tofacitinib, baricitinib, and upadacitinib, and filgotinib.

Major finding: Lymphocyte proliferation was similar for tofacitinib, baricitinib, and upadacitinib, while dosage of filgotinib was two orders of magnitude higher when these JAKis were added to peripheral blood mononuclear cells from healthy donors.

Study details: The data come from an in vitro study of four JAK inhibitors currently approved for the treatment of RA: tofacitinib, baricitinib, upadacitinib, and filgotinib, in which increasing concentrations of the JAKis or methotrexate were added to peripheral blood mononuclear cells from healthy volunteers.

Disclosures: The study was supported by the European Union Program Regional Development Fund of the Ministry of Economy, Science and Digitalisation in Saxony-Anhalt. Lead author Dr. Reddig had no financial conflicts to disclose.

Source: Reddig A et al. J Clin Med. 2021 Apr 1. doi: 103390/jcm10071431.

Key clinical point: Treatment of irradiated peripheral blood mononuclear cells (PBMCs) with filgotinib in particular correlated with enhanced foci in vitro; the study was a rare comparison of all four JAKis approved for RA: tofacitinib, baricitinib, and upadacitinib, and filgotinib.

Major finding: Lymphocyte proliferation was similar for tofacitinib, baricitinib, and upadacitinib, while dosage of filgotinib was two orders of magnitude higher when these JAKis were added to peripheral blood mononuclear cells from healthy donors.

Study details: The data come from an in vitro study of four JAK inhibitors currently approved for the treatment of RA: tofacitinib, baricitinib, upadacitinib, and filgotinib, in which increasing concentrations of the JAKis or methotrexate were added to peripheral blood mononuclear cells from healthy volunteers.

Disclosures: The study was supported by the European Union Program Regional Development Fund of the Ministry of Economy, Science and Digitalisation in Saxony-Anhalt. Lead author Dr. Reddig had no financial conflicts to disclose.

Source: Reddig A et al. J Clin Med. 2021 Apr 1. doi: 103390/jcm10071431.

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