Filgotinib, methotrexate combo effective for treating rheumatoid arthritis patients: BMJ

Delhi: A combination of filgotinib (FIL) and methotrexate (MTX) significantly improved signs and symptoms and physical function in active rheumatoid arthritis patients irrespective of prior or no MTX exposure, finds a recent study in the journal Annals of the Rheumatic Diseases. However, filgotinib monotherapy did not have superior ACR20 response rate compared to MTX monotherapy.

Previous studies found treatment with small-molecule Janus kinase (JAK) inhibitors, including upadacitinib, baricitinib, and tofacitinib to be be associated with significant improvement in clinical signs and symptoms of RA and radiographic progression in patients with no prior MTX exposure. However, the safety profile and risk for adverse events should be considered.

René Westhovens, University Hospitals KU Leuven, Leuven, Flanders, Belgium, and colleagues aimed to investigate the safety and efficacy of the Janus kinase-1 inhibitor filgotinib in patients with active RA with limited or no prior MTX exposure. 

For the purpose, the researchers conducted a 52-week, phase 3, multicentre, double-blind clinical trial. The researchers evaluated once-daily oral filgotinib in 1252 RA patients. They were randomized in the ratio of 2:1:1:2 to filgotinib 200 mg with MTX (FIL200 +MTX), filgotinib 100 mg with MTX (FIL100 +MTX), filgotinib 200 mg monotherapy (FIL200), or MTX.