Upadacitinib for the treatment of adult patients with active psoriatic arthritis.

IF 3.9 3区医学 Q2 IMMUNOLOGY Expert Review of Clinical Immunology Pub Date : 2024-05-01 Epub Date: 2023-12-28 DOI:10.1080/1744666X.2023.2299732

Antonio Marchesoni, Giorgia Citriniti, Nicolò Girolimetto, Niccolò Possemato, Carlo Salvarani

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Abstract

Introduction: Psoriatic arthritis (PsA) is a rheumatic disorder that may be responsible for relevant articular impairment. The recently licensed Janus Kinase (JaK) inhibitors represent a new opportunity to improve PsA treatment. This review deals with the clinical usefulness of the selective JaK-1 inhibitor upadacitinib (UPA) in patients with PsA.

Covered areas: Two phase-III studies are available: SELECT-PsA 1, performed in patients with an inadequate response to non-biological therapies, and SELECT-PsA 2, conducted in biologic-experienced patients. Long-term extension results and post-hoc analysis data of these two trials are also available.

Expert opinion: The results provided by the trials indicate that UPA may be used to treat all of the clinical manifestations of PsA. Venous thromboembolism, cardiovascular events, and malignancy, the most feared adverse events associated with JaK inhibitor use, were not increased in the trial populations, yet long-term observational studies are needed to make sure that UPA is safe in this respect.

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用于治疗活动性银屑病关节炎成年患者的奥帕他替尼。

导言：银屑病关节炎（PsA）是一种风湿性疾病，可能导致相关的关节损伤。最近获准上市的 Janus 激酶（JaK）抑制剂为改善 PsA 治疗带来了新机遇。本综述探讨了选择性JaK-1抑制剂乌达替尼（UPA）在PsA患者中的临床应用：目前有两项III期研究：SELECT-PsA 1针对对非生物疗法反应不佳的患者，SELECT-PsA 2针对有生物治疗经验的患者。这两项试验的长期延长结果和事后分析数据也已公布：试验结果表明，UPA可用于治疗PsA的所有临床表现。静脉血栓栓塞症、心血管事件和恶性肿瘤是使用JaK抑制剂最令人担忧的不良反应，但在试验人群中并未增加，但还需要进行长期观察研究，以确保UPA在这方面是安全的。

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来源期刊

Expert Review of Clinical Immunology IMMUNOLOGY-

CiteScore

7.60

自引率

2.30%

发文量

221

审稿时长

6-12 weeks

期刊介绍： Expert Review of Clinical Immunology (ISSN 1744-666X) provides expert analysis and commentary regarding the performance of new therapeutic and diagnostic modalities in clinical immunology. Members of the International Editorial Advisory Panel of Expert Review of Clinical Immunology are the forefront of their area of expertise. This panel works with our dedicated editorial team to identify the most important and topical review themes and the corresponding expert(s) most appropriate to provide commentary and analysis. All articles are subject to rigorous peer-review, and the finished reviews provide an essential contribution to decision-making in clinical immunology. Articles focus on the following key areas: • Therapeutic overviews of specific immunologic disorders highlighting optimal therapy and prospects for new medicines • Performance and benefits of newly approved therapeutic agents • New diagnostic approaches • Screening and patient stratification • Pharmacoeconomic studies • New therapeutic indications for existing therapies • Adverse effects, occurrence and reduction • Prospects for medicines in late-stage trials approaching regulatory approval • Novel treatment strategies • Epidemiological studies • Commentary and comparison of treatment guidelines Topics include infection and immunity, inflammation, host defense mechanisms, congenital and acquired immunodeficiencies, anaphylaxis and allergy, systemic immune diseases, organ-specific inflammatory diseases, transplantation immunology, endocrinology and diabetes, cancer immunology, neuroimmunology and hematological diseases.