Gecacitinib Pan JAK inhibitor in Radiographic axSpA Save
Dr. Antoni Chan reports on abstract OP0240 presented at the 2026 EULAR Congress in London
Transcription
I'm Anthony Chan reporting here from London at EULAR 2026 and I want to focus today on new treatments in the field of axial spondyloarthritis. Today there was a presentation on a pan-JAK inhibitor, geketinib, and this is in radiographic axial SpA. Geketinib is a pan-JAK inhibitor and this was presented in oral presentation OP-P240.
We have increasingly been introduced to the use of JAK inhibitors in the field of axial SpA. But it's quite important for us to know the differences between more selective JAK inhibitors and the more novel pan-JAK inhibitors such as this agent geketinib. And this was presented in radiographic axial SpA. This was a phase three result from the study.
We were looking at the impact in terms of the ASAS 40 — the primary endpoint was met. The ASAS 40 at week 16 was 52% in the geketinib group versus 13% with the placebo, so there was a significant difference of really about 39 percentage points, which met significance. When the bar was lowered to ASAS 20, this was about 70% in the active arm compared to 21% in the placebo group. So nearly four times the ASAS 20 response compared to the placebo group.
The secondary endpoints were also significantly superior in the treatment arm. This included the ASDAS-CRP, the BASMI, and also the quality of life studies. There was also some MRI data presented using the SPARCC score in both the sacroiliac joint and the spine, and this improved in the active arm compared to the placebo. There was consistency across both the biologic-naive groups and also the biologic-experienced groups, including those who had failed a prior TNF. So that is the efficacy both in terms of the objective measures and the radiographic change, but also in terms of safety. 93% of patients completed the 16-week period and there were no new safety signals seen for this new pan-JAK inhibitor.
So what have we learned from this? The insight would be here we see quite a big response in the ASAS 40 — 39 percentage points compared to the placebo. This is a phase three study. There were obviously some contexts that matter. These have to be replicated in other parts of the world. Mainly this was done in China in a multicenter trial. We have to look at different patient populations, disease duration, and also correct for baseline characteristics across other centers as well. The placebo rate was noted to be low at 13%, so I think that's quite interesting and important as well.
The question would be whether a pan-JAK inhibitor with broad immunological intervention would be different from more selective JAK blockade — whether this would lead to more complete cytokine suppression, which could possibly explain the higher response rates. But is this then traded for any safety signals in the long term?
This obviously brings to us another oral agent that we can look at — geketinib — and this now joins the other JAK inhibitors in presenting results in the field of axial spondyloarthritis. So one for us to be looking out for in the future, especially after patients who have anti-inflammatory failure, whether these agents could be used earlier in the disease.
I'm Anthony Chan reporting here in London for RheumNow, EULAR 2026. Thanks.
We have increasingly been introduced to the use of JAK inhibitors in the field of axial SpA. But it's quite important for us to know the differences between more selective JAK inhibitors and the more novel pan-JAK inhibitors such as this agent geketinib. And this was presented in radiographic axial SpA. This was a phase three result from the study.
We were looking at the impact in terms of the ASAS 40 — the primary endpoint was met. The ASAS 40 at week 16 was 52% in the geketinib group versus 13% with the placebo, so there was a significant difference of really about 39 percentage points, which met significance. When the bar was lowered to ASAS 20, this was about 70% in the active arm compared to 21% in the placebo group. So nearly four times the ASAS 20 response compared to the placebo group.
The secondary endpoints were also significantly superior in the treatment arm. This included the ASDAS-CRP, the BASMI, and also the quality of life studies. There was also some MRI data presented using the SPARCC score in both the sacroiliac joint and the spine, and this improved in the active arm compared to the placebo. There was consistency across both the biologic-naive groups and also the biologic-experienced groups, including those who had failed a prior TNF. So that is the efficacy both in terms of the objective measures and the radiographic change, but also in terms of safety. 93% of patients completed the 16-week period and there were no new safety signals seen for this new pan-JAK inhibitor.
So what have we learned from this? The insight would be here we see quite a big response in the ASAS 40 — 39 percentage points compared to the placebo. This is a phase three study. There were obviously some contexts that matter. These have to be replicated in other parts of the world. Mainly this was done in China in a multicenter trial. We have to look at different patient populations, disease duration, and also correct for baseline characteristics across other centers as well. The placebo rate was noted to be low at 13%, so I think that's quite interesting and important as well.
The question would be whether a pan-JAK inhibitor with broad immunological intervention would be different from more selective JAK blockade — whether this would lead to more complete cytokine suppression, which could possibly explain the higher response rates. But is this then traded for any safety signals in the long term?
This obviously brings to us another oral agent that we can look at — geketinib — and this now joins the other JAK inhibitors in presenting results in the field of axial spondyloarthritis. So one for us to be looking out for in the future, especially after patients who have anti-inflammatory failure, whether these agents could be used earlier in the disease.
I'm Anthony Chan reporting here in London for RheumNow, EULAR 2026. Thanks.
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