Simponi (golimumab)

Biological TNF-α inhibitors - etanercept, infliximab, adalimumab, golimumab, and certolizumab pegol - were primarily developed to control inflammation but have also demonstrated potential skeletal benefits, such as preservation or modest improvement in BMD and favorable modulation of bone turnover markers. This review synthesizes mechanistic and clinical evidence on TNF-α-mediated bone loss across diverse inflammatory diseases, evaluates the bone-protective potential of TNF-α inhibitors, and highlights shared pathogenic mechanisms and therapeutic considerations to guide future research.

P=N/A, N=4000, Active, not recruiting, Pfizer | Recruiting --> Active, not recruiting

P2, N=35, Recruiting, Sun Yat-sen University | Not yet recruiting --> Recruiting | Trial completion date: Dec 2026 --> Dec 2028 | Trial primary completion date: Dec 2026 --> Jul 2027

To report a case of AA developing during golimumab and leflunomide treatment for seropositive rheumatoid arthritis, with subsequent improvement following initiation of selective Janus kinase 1 (JAK1) inhibition...Upadacitinib was initiated for rheumatoid arthritis management and escalated from 15 mg to 30 mg...Although spontaneous remission and delayed corticosteroid effects cannot be excluded, the timing and magnitude of improvement support a temporal association with JAK1 inhibition. This case highlights a pragmatic therapeutic consideration when alopecia arises during TNF-α inhibitor therapy.

P=N/A, N=4000, Recruiting, Pfizer | Not yet recruiting --> Recruiting

P2, N=8, Active, not recruiting, University of Washington | Trial completion date: Apr 2026 --> Apr 2027

P4, N=300, Active, not recruiting, Erasmus Universitair Medisch Centrum Rotterdam (Erasmus MC) | Not yet recruiting --> Active, not recruiting

P=N/A, N=95, Not yet recruiting, Assiut University

P2, N=8, Active, not recruiting, University of Washington | Recruiting --> Active, not recruiting | N=34 --> 8 | Trial completion date: Dec 2027 --> Apr 2026 | Trial primary completion date: Mar 2027 --> Jul 2025

Uveitis exposure-adjusted incidence rates per 100 patient years (EAIR/100PY) ranged between 0-4.5 for tumour necrosis factor inhibitors (TNFi), 0.5-3.9 for interleukin-17 inhibitors (IL-17i) and 0.8-3.3 for upadacitinib (UPA), as derived from available RCTs. Evidence from non-RCTs, reporting uveitis incidence rates per 100PY, ranged between 3.46-55.2 for etanercept, 1.38-15.7 for adalimumab, 1.82-25.9 for infliximab, 1.39-6.8 for golimumab, 0-9.4 for secukinumab and 0 for ixekizumab...IL-17i are identified as second line treatment option especially in uveitis refractory to TNFi. Finally, JAKi remain a promising alternative, with more evidence needed to further establish their so far proven efficacy.

The JSpA in this cohort demonstrated substantial disease burden, with frequent axial and peripheral involvement. Although 43.2% of patients achieved clinical remission, sustained remission off medication was observed in only 10.2%, reflecting the chronic disease course. Early diagnosis and optimized treatment strategies remain essential to improve outcomes.

This comprehensive analysis assesses therapeutic outcomes and adverse effects of TNFi, IL17i, and JAKi in AS care.