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Filgotinib in rheumatoid arthritis

Rene Westhovens1

  • 1Emeritus Professor KU Leuven, Skeletal Biology and Engineering Research Center Department of Development and Regeneration, Leuven, Belgium.

Expert Review of Clinical Immunology
|November 17, 2022
PubMed
Abstract

Insights

Filgotinib, a new Janus kinase inhibitor (JAKi), shows efficacy in Rheumatoid Arthritis (RA) treatment. Its preferential JAK1 inhibition may contribute to a favorable safety profile, though further confirmation is needed.

Area of Science:

  • Rheumatology
  • Pharmacology
  • Immunology

Background:

  • Rheumatoid Arthritis (RA) management remains challenging despite advanced strategies.
  • Janus kinase inhibitors (JAKi) represent a novel class of targeted oral therapies for RA.
  • Filgotinib is a new JAKi approved for RA, with preferential JAK1 inhibition.

Approach:

  • This narrative review synthesizes available literature on filgotinib's characteristics, efficacy, and safety in RA patients.
  • Detailed analysis of clinical trial data is provided, contextualized for clinical practice and regulatory considerations.

Key Points:

  • Preclinical data show preferential JAK1 inhibition and favorable pharmacokinetics with minimal drug-drug interactions.
  • Clinical trials indicate increased hemoglobin levels, consistent with JAK1 selectivity over JAK2.
  • Phase III trials demonstrate filgotinib's efficacy across various RA disease stages, with a potential dose-dependent effect.

Conclusions:

  • Filgotinib exhibits efficacy in RA, with a potentially favorable safety profile, including manageable side effects like herpes zoster and lipid changes.
  • The role of preferential JAK1 inhibition in filgotinib's safety profile requires further investigation.
  • Long-term safety data in real-world clinical practice are essential for comprehensive understanding.
Keywords:
FilgotinibJAK1janus kinaserheumatoid arthritistyrosine kinase inhibitors

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