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New indications for JAK inhibitors

Janet Pope, MD, MPH, FRCPC

There are several new positive RCTs for JAK inhibitors. Here is a summary of trials and new indications for JAKi in GCA, pediatrics, GI, dermatology and more.

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Damage in Childhood Lupus

EurekAlert!

Childhood lupus (cSLE) is a rare multisystem disorder with significant associated morbidity, but evidence-based guidelines are sparse, and as such management is often based on clinical expertise.

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Is Cannabis Safe? (6.7.2024)

Jack Cush, MD

Dr. Jack Cush reviews FDA approval, news and journal articles -- and it’s the week before EULAR 2024 in Vienna!!

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Pharmacologic Efficacy in Still's Disease

Jack Cush, MD

A systematic review of the effectiveness and safety of pharmacological treatments for adult-onset Still’s disease (AOSD) supports the use of either IL-1 or IL-6 inhibitors.

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Cutoffs for Systemic Juvenile Arthritis Disease Activity Score

Jack Cush, MD

An international cohort of children with systemic Juvenile idiopathic arthritis (Still's disease) validated the systemic Juvenile Arthritis Disease Activity Score 10 (sJADAS10), a disease activity measure distinguish patients with inactive disease, minimal disease activity, moderate disease activity, and high disease activity.

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Featured BSR Abstracts (5.2.2024)

Jack Cush, MD

Dr. Jack Cush muses on the news, journal reports, FDA announcements and the 2024 BSR abstracts just released.

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Methotrexate Does Not Increase ILD Risk in Dermatomyositis

Jack Cush, MD

A cohort analysis of dermatomyositis (DM) patients starting immunomodulators finds that methotrexate use was not associated with an increased risk of interstitial lung disease (ILD).

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Rheum Chapter Notes (4.26.2024)

Jack Cush, MD

Dr. Jack Cush reviews this past week’s news and journal articles from RheumNow.com.

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Canary in a Coal Mine (4.19.2024)

Jack Cush, MD

Dr. Jack Cush reviews regulatory reports, news and novel journal articles - this week focusing on Sjogren's, ILD, Gout and Uveitis.

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Seasonal Pathogens and Henoch-Schönlein Purpura

Jack Cush, MD

Epidemiologic studies of Henoch-Schönlein purpura (HSP) have suggested seasonal variation in occurrence rates (higher from September-April, lower in June-August), suggesting a role for infectious triggers.

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Abbvie announced upadacitinib (Rinvoq) is approved for use in polyarticular JIA and Psoriatic Arthritis (in children 2 years of age and older who have had an inadequate response or intolerance to 1 or more tumor necrosis factor (TNF) blockers) https://t.co/I4Wu49xGxy https://t.co/nTwgfRG1qG

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Dr. John Cush RheumNow ( View Tweet)
#EULAR2024 LBA0009 Phase 3 Open label H2H RCT of Ixekizumab vs in jPsA & enthesitis-related arthritis showed similar ACR30 response rates at Wk16 (IXE=89%; ADA=95%). Open label and long-term follow up for IXE is ongoing to assess for sustainment @Yuz6Yusof https://t.co/eSqOkBGBK2
Dr. John Cush RheumNow ( View Tweet)
#EULAR2024 POS1325 Childhood onset #lupus is often more severe with high mortality rate. Similar to findings in adults, 2 cSLE patients with refractory disease including failure to CyC, RTX & PLEX responded to CD19 CAR T cells with similar short term safety profile @RheumNow https://t.co/YD2arjxcso

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
#EULAR2024 LBA0009 Phase 3 Open label H2H RCT of Ixekizumab vs in jPsA & enthesitis-related arthritis showed similar ACR30 response rates at Wk16 (IXE=89%; ADA=95%). Open label and long-term follow up for IXE is ongoing to assess for sustainment @RheumNow https://t.co/lk42I7Mn8B

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Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
New #JAKi #disease #results #Baricitinib in #alopecia #areata esp 4mg/d #Upadacitinib in Crohn’s #Upa in #polyarticular #JIA & kid #PsA +RCT of UPA in #GCA Awaiting results of #SLE With #deucravicitinib & UPA #RCTs #EULAR2024 @eular_org @RheumNow

Janet Pope Janetbirdope ( View Tweet)

FDA has approved upadacitinib (Rinvoq), for use in pediatric patients (age >2 years) w/ active polyarticular juvenile idiopathic arthritis (pJIA) & psoriatic arthritis (PsA), after inadequate resp/intolerance to TNFi. Also available as oral solution. https://t.co/dZ21V2cKwR https://t.co/QADVP2w3Tz

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Dr. John Cush RheumNow ( View Tweet)
Systemic sclerosis sine scleroderma in children is more aggressive than in adults. 18 juvenile vs 38 adults - ssJSSc more female (39% vs 89%), more digital pitting scars/ulcers (35 vs 10.5%), Pulm (50 vs 24) & CV (50 vs 3%); w/ more deaths https://t.co/l4f5bH1IX1 https://t.co/viQcD3tN9V

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Dr. John Cush RheumNow ( View Tweet)
Metanalysis of 26 reports and 195 juvenile Dermatomyositis pts (age 4.9 yrs) treated w/ JAK inhib (tofa, rux, & bari); Good improvement in 90%, 69% & 93%, respectively. JAK indication refractory skin dz (35%) or muscle involvement (29%). TIME FOR RCTs!! https://t.co/Vtm2n9BWV1 https://t.co/1bXZokW1AO

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Dr. John Cush RheumNow ( View Tweet)
Pediatric IMID pts have 4 fold mortality. Danish population study of 11,581 pIMID (vs 99K controls), 1.37 million PYs F/U. Dx age 12.6 yrs; 152 pIMID deaths (vs 316) aHR=3.8. +6.9 deaths/100K PYs. Most for GI Dz/CA & lymphoproliferative dz https://t.co/JpGzusLXMH https://t.co/OMtB1z0RmG

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Dr. John Cush RheumNow ( View Tweet)
Mental health in 1150 adolescents & young adults w/ juvenile idiopathic arthritis (age 15.6 yrs; Dz duration 7.2 yrs, 43% oligo-, 26% polyarthritis): 30% reported suicidal thoughts, 19% mod-severe depressive/anxious Sxs (moreso in Females OR 2.33) https://t.co/THW1IMqZpa https://t.co/IU2Kr3efYj

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Dr. John Cush RheumNow ( View Tweet)
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