Filgotinib in patients with rheumatoid arthritis found to be
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A research was performed to evaluate the efficacy and safety of the Janus kinase-1-preferential inhibitor filgotinib versus placebo or tumour necrosis factor-alpha inhibitor therapy in patients with active rheumatoid arthritis (RA) despite ongoing treatment with methotrexate (MTX).

This 52-week, multicentre, double-blind, placebo-controlled and active-controlled phase III trial evaluated once-daily oral filgotinib in patients with RA randomised 3:3:2:3 to filgotinib 200?mg (FIL200) or filgotinib 100?mg (FIL100), subcutaneous adalimumab 40?mg biweekly, or placebo (through week 24), all with stable weekly background MTX. The primary endpoint was the proportion of patients achieving 20% improvement in American College of Rheumatology criteria (ACR20) at week 12.

--The proportion of patients (n=1755 randomised and treated) achieving ACR20 at week 12 was significantly higher for FIL200 (76.6%) and FIL100 (69.8%) versus placebo.

--Filgotinib was superior to placebo in key secondary endpoints assessing RA signs and symptoms, physical function and structural damage.

--FIL200 was non-inferior to adalimumab in terms of Disease Activity Score in 28 joints with C reactive protein less than 3.2 at week 12, FIL100 did not achieve non-inferiority.

--Adverse events and laboratory abnormalities were comparable among active treatment arms.

In conclusion, Filgotinib improved the signs and symptoms of RA, improved physical function, prevented the progression of radiography, and was well tolerated in patients with RA who did not respond adequately to MTX. FIL200 was non-adalimumab-inferior.