Filgotinib may improve MRI structural lesions in ankylosing spondylitis
medwireNews: A post-hoc analysis of data from the TORTUGA trial shows that treatment with filgotinib is associated with beneficial changes in magnetic resonance imaging (MRI) structural lesions in people with ankylosing spondylitis (AS).
The main findings from the phase 2 randomized trial, reported previously by medwireNews, showed that the Janus kinase (JAK)1 selective inhibitor reduced disease activity and improved symptoms relative to placebo in patients with active AS and an inadequate response to nonsteroidal anti-inflammatory drugs.
For the post-hoc analysis, Walter Maksymowych (University of Alberta, Edmonton, Canada) evaluated sacroiliac joint MRI scans from 87 participants, finding that erosion scores decreased by an average of 0.46 points from baseline to week 12 in the 48 patients given filgotinib but increased by an average of 0.56 points in the 39 patients given placebo, giving a significant least squares mean difference of 1.01 points between the groups.
Participants treated with filgotinib also experienced a significant increase in backfill score – indicative of the replacement of inflammatory erosive lesions with new tissue – compared with those given placebo, and these structural changes correlated with reduction in inflammation with the JAK inhibitor, say the researchers.
“Research is needed to confirm these findings in larger clinical trials, and the prognostic implications of the structural changes observed in this analysis for disease/ankylosis progression warrant further research,” conclude the investigators in Rheumatology.
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