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Rheumatoid arthritis

Developing new oral targeted therapies for RA can be challenging

The positive results of the phase II programme of fostamatinib, developed to target the spleen tyrosine kinase pathway in rheumatoid arthritis (RA), have not been replicated in phase III. What implications might the results have for the development of other oral inhibitors of intracellular kinases in the treatment of RA?

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References

  1. O'Shea, J. J., Laurence, A. & McInnes, I. B. Back to the future: oral targeted therapy for RA and other autoimmune diseases. Nat. Rev. Rheumatol. 9, 173–182 (2013).

    Article  Google Scholar 

  2. Mócsai, A., Ruland, J. & Tybulewicz, V. L. The SYK tyrosine kinase: a crucial player in diverse biological functions. Nat. Rev. Immunol. 10, 387–402 (2010).

    Article  Google Scholar 

  3. Weinblatt, M. E. et al. Effects of fostamatinib, an oral spleen tyrosine kinase inhibitor, in rheumatoid arthritis patients with an inadequate response to methotrexate: results from a phase III, multicenter, randomized, double-blind, placebo-controlled, parallel-group study. Arthritis Rheumatol. http://dx.doi.org/10.1002/art.3885.

  4. Genovese, M. C. et al. A phase III, multicenter, randomized, double-blind, placebo-controlled, parallel-group study of 2 dosing regimens of fostamatinib in patients with rheumatoid arthritis with an inadequate response to a tumor necrosis factor-α antagonist. J. Rheumatol. http://dx.doi.org/10.3899/jrheum.140238 (2014).

  5. Weinblatt, M. E. et al. Treatment of rheumatoid arthritis with a Syk kinase inhibitor: a twelve-week, randomized, placebo-controlled trial. Arthritis Rheum. 58, 3309–3318 (2008).

    Article  CAS  Google Scholar 

  6. Weinblatt, M. E. et al. Effects of fostamatinib (R788), an oral spleen tyrosine kinase inhibitor, on health-related quality of life in patients with active rheumatoid arthritis: analyses of patient-reported outcomes from a randomized, double-blind, placebo-controlled trial. J. Rheumatol. 40, 369–378 (2013).

    Article  CAS  Google Scholar 

  7. Fleischmann, R. et al. Placebo-controlled trial of tofacitinib monotherapy in rheumatoid arthritis. N. Engl. J. Med. 367, 495–507 (2012).

    Article  CAS  Google Scholar 

  8. Van Vollenhoven, R. et al. Tofacitinib or adalimumab versus placebo in rheumatoid arthritis. N. Engl. J. Med. 367, 508–519 (2012).

    Article  CAS  Google Scholar 

  9. Burmester, G. R. et al. Tofacitinib (CP-690,550) in combination with methotrexate in patients with active rheumatoid arthritis with an inadequate response to tumour necrosis factor inhibitors: a randomised phase 3 trial. Lancet 381, 451–460 (2013).

    Article  CAS  Google Scholar 

  10. Genovese, M. C. et al. 24-week results of a blinded phase 2b dose-ranging study of baricitinib, an oral Janus kinase 1/Januse kinase 2 inhibitor, in combination with traditional disease modifying antirheumatic drugs in patients with rheumatoid arthritis [abstract 2487]. Arthritis Rheum. 64 (Suppl.), S1049–S1050 (2012).

    Google Scholar 

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Correspondence to Roy M. Fleischmann.

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Fleischmann, R. Developing new oral targeted therapies for RA can be challenging. Nat Rev Rheumatol 11, 4–6 (2015). https://doi.org/10.1038/nrrheum.2014.187

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