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25-07-2021 | Rheumatoid arthritis | Adis Journal Club | Article

Clinical Drug Investigation

Filgotinib in Rheumatoid Arthritis: A Profile of Its Use

Authors: Esther S. Kim & Susan J. Keam

Abstract

Filgotinib (Jyseleca®), an oral Janus kinase (JAK) inhibitor, is approved as monotherapy or in combination with methotrexate to treat moderate to severe active rheumatoid arthritis (RA) in adults who have an inadequate response or intolerance to one or more disease-modifying antirheumatic drugs (DMARDs). In phase 3 trials, once-daily filgotinib was generally well tolerated and associated with an improvement in RA signs and symptoms as well as physical function in patients with an inadequate response to ongoing methotrexate, an inadequate response to ongoing conventional synthetic DMARDs plus an inadequate response or intolerance to prior biologic DMARDs, or limited or no prior exposure to methotrexate. In addition, filgotinib was noninferior to adalimumab in terms of low disease activity response rate (DAS28-CRP ≤ 3.2) in patients with an inadequate response to methotrexate. Filgotinib also appeared to inhibit the radiographic progression of joint damage and led to low disease activity or disease remission (DAS28-CRP < 2.6). Filgotinib showed sustained efficacy, and the safety profile of filgotinib longer term was similar to that in the phase 2 and 3 trials.

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Adis evaluation of filgotinib in RA

Second-generation JAK inhibitor with preferential inhibition of JAK1 over JAK2, JAK3 and TYK2.

As monotherapy or combination therapy, improves RA signs and symptoms as well as physical function and inhibits the progression of structural joint damage.

Noninferior to adalimumab in terms of achieving low disease activity.

Generally well tolerated.

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