Publications by authors named "Peter Nash"
Objective: To assess long-term tofacitinib efficacy and safety in patients with PsA with or without prior biologic DMARD (bDMARD) exposure.
Methods: Data were pooled post hoc from three phase 3 and one long-term extension (LTE) PsA studies and stratified by TNF inhibitor-inadequate responder (TNFi-IR) or bDMARD-naïve patient status at the phase 3 study baseline. Data were reported as all tofacitinib (patients receiving one or more tofacitinib doses) or average tofacitinib 5 and 10 mg twice daily (patients receiving an average total daily dose <15 and ≥15 mg, respectively).
In light of the introduction of new Janus kinase inhibitors (JAKi), new indications for JAKi and recent safety considerations that have arisen since the preceding consensus statement on JAKi therapy, a multidisciplinary taskforce was assembled, encompassing patients, health care professionals, and clinicians with expertise in JAKi therapy across specialties. This taskforce, informed by two comprehensive systematic literature reviews, undertook the objective to update the previous expert consensus for using JAKi developed in 2019. The taskforce deliberated on overarching principles, indications, dosage and comedication strategies, warnings and contraindications, screening protocols, monitoring recommendations, and adverse effect profiles.
View Article and Find Full Text PDFObjective: This systematic literature review (SLR) on efficacy outcomes was performed to inform the 2024 update of the expert consensus statement on the treatment of immune-mediated inflammatory diseases (IMIDs) with Janus kinase inhibitors (JAKi).
Methods: An update of the 2019 SLR was performed in MEDLINE, Embase, and the Cochrane Library. For efficacy, randomised, placebo (PLC)- or active-controlled trials on all JAKi investigated in IMIDs, as well as cohort and claims data for conditions where such studies were not available, were included.
Objectives: This systematic literature review (SLR) on safety outcomes was performed to inform the 2024 update of the expert consensus statement on the treatment of immune-mediated inflammatory diseases (IMIDs) with Janus kinase inhibitors (JAKi).
Methods: An update of the 2019 SLR was performed in MEDLINE, Embase, and the Cochrane Library. For safety, randomised, placebo-controlled or active-controlled trials on all JAKi investigated in IMIDs, long-term extension (LTE) studies, pooled trial data analyses, and cohort and claims studies were included.
Background: Data on treatment switching directly from tumor necrosis factor inhibitors to tofacitinib in psoriatic arthritis (PsA) are limited. This post hoc analysis assessed efficacy and safety outcomes in patients with PsA who directly switched to tofacitinib in a long-term extension (LTE) study after receiving adalimumab (ADA) in a Phase 3 study, compared with those who continued to receive tofacitinib.
Methods: Patients with active PsA received tofacitinib 5 mg twice daily (BID) or ADA 40 mg once every 2 weeks in a 12-month, randomized, double-blind study (OPAL Broaden) and then continued or switched to tofacitinib 5 mg BID and maintained this dose in an open-label LTE study (OPAL Balance).
Introduction: We aim to assess the association of patient-reported pain and remission or low disease activity (LDA) at 3 months (M) in patients receiving baricitinib or other treatments in RA-BE-REAL.
Methods: RA-BE-REAL reports on patients with rheumatoid arthritis (RA) who were prescribed, for the first time, baricitinib (cohort A) or a tumour necrosis factor inhibitor (TNFi) (cohort B-TNFi) or any other mode of action (OMA) (cohort B-OMA). Pain was measured using the visual analogue scale (VAS) (0-100 mm) and clinically meaningful pain improvement thresholds of ≥ 30%, ≥ 50% and ≥ 70% from baseline to 3, 6, 12 and 24 M.
A review and recommendations on the management of psoriatic arthritis in Australia 2024.
Intern Med J
December 2024
Article Synopsis
- * A panel of six experts in Australia created management recommendations for PsA, which received approval from all members.
- * The guidelines cover various aspects, including medication options, treatment monitoring, family planning, symptom management, and lifestyle considerations, aiming to help doctors provide better patient care.
Background: Psoriatic arthritis (PsA) is a chronic inflammatory disease that causes pain and fatigue, reduces physical function, and negatively impacts health-related quality of life (HRQoL). In the phase III BE OPTIMAL and BE COMPLETE studies, bimekizumab demonstrated clinical efficacy and meaningful improvements in patient-reported outcome (PRO) measures in biologic disease-modifying antirheumatic drug (bDMARD)-naïve patients, and those who had prior inadequate response/intolerance to tumor necrosis factor inhibitors (TNFi-IR).
Objectives: To examine the association between achieving increasingly stringent clinical disease control criteria and improvements in PRO measures in patients with active PsA receiving bimekizumab.
Article Synopsis
- The study evaluates the long-term safety and effectiveness of filgotinib at 100 mg and 200 mg doses in Japanese patients with rheumatoid arthritis.
- Patients from prior studies who finished without rescue therapy transitioned into a long-term extension study, with most continuing their original filgotinib dose.
- Results show that filgotinib was well tolerated, with some patients achieving higher clinical remission rates, particularly those with prior exposure to FIL200.
What have we learnt from the inhibition of IL-6 in RA and what are the clinical opportunities for patient outcomes?
Ther Adv Musculoskelet Dis
October 2024
Article Synopsis
- Rheumatoid arthritis (RA) is an autoimmune disease causing chronic inflammation in joints and other organs, leading to potential joint damage and increased health risks if not properly managed.
- Interleukin-6 (IL-6) is a key cytokine involved in RA, making it a significant target for treatment; therapies like tocilizumab can block IL-6 receptors and help reduce inflammation.
- Personalizing RA treatment based on individual patient profiles and addressing related health issues can improve outcomes, with a focus on a 'treat-to-profile' strategy that considers the patient's overall health.
Article Synopsis
- The phase 3 DISCOVER-2 trial evaluated the effectiveness of guselkumab in treating psoriatic arthritis (PsA), focusing on individual patient outcomes rather than just group trends.
- Post hoc analyses showed that a high percentage (93% to 99%) of patients maintained significant clinical improvements in joint disease at scheduled dosing visits and sustained these improvements over time.
- Guselkumab demonstrated long-lasting benefits, with many patients continuing to experience improvements 100 weeks after achieving clinical milestones, indicating its potential as a robust treatment option for PsA.
Article Synopsis
- The study assessed the effectiveness of bimekizumab versus risankizumab in treating psoriatic arthritis (PsA) over 52 weeks, focusing on patients either new to biologic treatment (bDMARD naïve) or those who had previously not responded to tumor necrosis factor inhibitors (TNFi-IR).
- Data from relevant clinical trials were matched and analyzed using statistical methods to account for differences between the trial populations, ensuring a fair comparison of outcomes like the American College of Rheumatology (ACR) response criteria and minimal disease activity (MDA).
- Results indicated that bimekizumab showed a significantly higher likelihood of response at Wk52 compared to ris
Article Synopsis
- A matching-adjusted indirect comparison (MAIC) was performed to evaluate the efficacy of bimekizumab versus ustekinumab in treating psoriatic arthritis patients, focusing on those who are naïve to biologic drugs or had previously inadequate responses to tumor necrosis factor inhibitors.
- Individual patient data from two bimekizumab trials were matched with summary data from multiple ustekinumab trials, using propensity scores to balance baseline characteristics.
- Results showed that bimekizumab had significantly higher response rates for various American College of Rheumatology (ACR) criteria at 52 weeks compared to ustekinumab in both bDMARD naïve and TNFi-IR patients.
Article Synopsis
- The study investigates how achieving clinical disease control impacts patient-reported outcomes (PROs), especially quality of life (QoL), in individuals with psoriatic arthritis (PsA).
- It analyzes data from two long-term clinical trials involving patients whose responses to standard treatments were inadequate, highlighting the effectiveness of upadacitinib and adalimumab.
- Results show that patients reaching minimal disease activity (MDA) or very low disease activity (VLDA) significantly report better QoL and health status compared to those who do not achieve such control, indicating a strong link between clinical improvements and PROs.
Objective: This post hoc analysis assessed the effect of baseline C-reactive protein (CRP) on the efficacy and safety of tofacitinib (TOF) use in ankylosing spondylitis (AS), as well as patient-reported outcomes (PROs).
Methods: Phase II (ClinicalTrials.gov: NCT01786668) and phase III (ClinicalTrials.
Objective: Evaluate long-term guselkumab effectiveness across Group for Research and Assessment of Psoriasis and Psoriatic Arthritis (GRAPPA)-recognised domains/related conditions of psoriatic arthritis (PsA).
Methods: Post hoc analyses used data from DISCOVER-2 (NCT03158285) biologic/Janus-kinase inhibitor-naïve participants with active PsA (≥5 swollen/≥5 tender joints, C-reactive protein ≥0.6 mg/dL), randomised (1:1:1) to guselkumab every 4 or 8 weeks (Q4W/Q8W) or placebo with crossover to guselkumab.
Objective: New modes of action and more data on the efficacy and safety of existing drugs in psoriatic arthritis (PsA) required an update of the EULAR 2019 recommendations for the pharmacological treatment of PsA.
Methods: Following EULAR standardised operating procedures, the process included a systematic literature review and a consensus meeting of 36 international experts in April 2023. Levels of evidence and grades of recommendations were determined.
Article Synopsis
- - The study utilized matching-adjusted indirect comparisons (MAIC) to evaluate the effectiveness of bimekizumab versus guselkumab in treating patients with psoriatic arthritis who had not previously received biologic therapy or had inadequate responses to TNF inhibitors.
- - Data were collected from systematic literature reviews and multiple clinical trials, allowing for comparisons of treatment outcomes based on individual patient data and summary data from various studies.
- - Results showed that bimekizumab was significantly more effective than guselkumab in achieving higher rates of improvement in American College of Rheumatology scores and minimal disease activity in both treatment-naïve and TNFi-resistant patient groups.
Article Synopsis
- The analysis looked at how filgotinib affects pain management in rheumatoid arthritis (RA) patients, based on data from the FINCH 1-3 studies.
- Results showed that filgotinib started reducing pain by week 2, with sustained improvement observed throughout the studies.
- In comparison to other treatments, filgotinib 200 mg led to better pain reduction and higher rates of patients achieving low pain levels and remission compared to filgotinib 100 mg and adalimumab.
Article Synopsis
- The study used Matching-Adjusted Indirect Comparisons (MAICs) to evaluate the effectiveness of bimekizumab versus secukinumab in treating psoriatic arthritis after 52 weeks of treatment in patients who had either never received biologics or had inadequate responses to TNF inhibitors.
- Patients from two bimekizumab trials had their data matched to aggregate data from another trial involving secukinumab to ensure fair comparisons based on similar baseline characteristics.
- The results indicated that bimekizumab showed a significantly higher likelihood of achieving major improvement scores (ACR20/50/70) and minimal disease activity compared to both doses of secukinumab in both
Article Synopsis
- The study aimed to evaluate the effectiveness and safety of bimekizumab, a drug targeting specific proteins in the immune system, compared to other treatments for Psoriatic Arthritis (PsA) through a network meta-analysis.
- A systematic review of randomized controlled trials identified 41 studies involving 22 different biologic and targeted synthetic DMARDs to analyze their outcomes at 12-24 weeks.
- Results indicated that bimekizumab performed well in achieving minimal disease activity and other response measures, ranking highly for both new and experienced patients, with a safety profile similar to other treatments, making it a promising option for PsA patients.
Article Synopsis
- The study focused on analyzing major adverse cardiovascular events (MACEs) and venous thromboembolism (VTE) in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) who were treated with upadacitinib in clinical trials.
- Data included a total of 6,423 patients and compared the rates of MACEs and VTE between different doses of upadacitinib (15 mg and 30 mg) and traditional treatments like adalimumab and methotrexate.
- The findings revealed that rates of MACEs and VTE were consistent across treatment groups, with most events occurring in patients with multiple cardiovascular risk factors,
Article Synopsis
- This study aims to compare the effectiveness of targeted synthetic and biologic DMARDs in treating psoriatic arthritis (PsA) through a network meta-analysis, addressing the lack of head-to-head clinical trials in this area.
- A systematic literature review included 26 Phase III randomized controlled trials assessing patient-reported outcomes like HAQ-DI and SF-36 scores, with thorough data extraction and bias assessment procedures.
- Results showed that intravenous TNF alpha inhibitors generally performed better for HAQ-DI and SF-36 scores, while various interleukin agents provided comparable improvements across outcomes.