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Focus on Filgotinib in Rheumatoid Arthritis: A Trial-Based Review

Elpida Skouvaklidou1, Dimitrios Deligeorgakis1, Anastasia Skalkou1

  • 1Department of Rheumatology, 4th Department of Internal Medicine, Hippokration Hospital, Thessaloniki, Greece.

Mediterranean Journal of Rheumatology
|May 17, 2024
PubMed

Insights

Filgotinib, a JAK1 inhibitor, demonstrates sustained efficacy in rheumatoid arthritis (RA) and ulcerative colitis, improving disease activity and quality of life. While generally safe, it carries an increased risk of infections, excluding herpes zoster.

Area of Science:

  • Rheumatology
  • Immunology
  • Pharmacology

Background:

  • The Janus kinases (JAK)/Signal Transducer and Activator of Transcription (STAT) pathway plays a crucial role in the development of various rheumatic diseases.
  • JAK inhibitors offer effective treatment options for rheumatoid arthritis (RA), providing sustained therapeutic benefits.
  • Filgotinib, a selective JAK1 inhibitor, is approved for RA and ulcerative colitis, expanding therapeutic choices.

Purpose of the Study:

  • To analyze the efficacy of filgotinib in patients with rheumatoid arthritis.
  • To review drug-specific safety warnings associated with filgotinib treatment.
  • To evaluate filgotinib's performance in various patient populations and against other treatments.

Main Methods:

  • Review of randomized clinical trials involving patients with RA, including those treatment-naïve, csDMARD-experienced, or bDMARD-experienced.
  • Analysis of filgotinib's efficacy compared to placebo, methotrexate, and adalimumab.
  • Inclusion of data from long-term extension trials up to four years of continuous filgotinib administration.

Main Results:

  • Filgotinib demonstrated longitudinal efficacy in improving disease activity parameters and quality of life in moderate to severe RA.
  • In a head-to-head comparison, filgotinib 200 mg was found to be non-inferior to adalimumab.
  • A notable safety warning includes an elevated risk of infectious adverse effects, with a low incidence of herpes zoster infection.

Conclusions:

  • Filgotinib offers sustained efficacy for moderate to severe RA patients, impacting both disease activity and quality of life.
  • The drug's safety profile indicates a higher risk of infections, though herpes zoster incidence is low.
  • Filgotinib represents a valuable therapeutic option within the JAK inhibitor class for managing RA.
Keywords:
Janus kinasesefficacyfilgotinibrandomised clinical trialsrheumatoid arthritissafety

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