Filgotinib is a therapy that the Galapagos pharmaceutical company is developing for ankylosing spondylitis,  a progressive type of arthritis that mainly affects the spine and sacroiliac joints — those between the spine and pelvis.

Galapagos uses patient and other human cells to look for cell proteins that play important roles in causing diseases such as AS. It then develops drugs that inhibit the proteins in an attempt to slow or stop the course of the disease. This approach addresses the root cause of the disease rather than just treating its symptoms.

Clinical trials indicate that filgotinib acts rapidly against the abnormal proteins in AS, is safe, and patients tolerate it well.  The trials have involved more than 1,600 people with rheumatoid arthritis and Crohn’s disease.

How filgotinib works

Filgotinib is a Janus kinase 1 (JAK1) inhibitor. Janus kinases (JAK) play a key role in transmitting signals from cytokines, or growth factors, into a cell. By inhibiting JAK, filgotinib blocks the pathway leading to spinal inflammation.

Filgotinib in clinical trials for AS

A Phase 2 proof-of-concept trial (NCT03117270) is investigating the safety and effectiveness oas an AS therapy.

The TORTUGA study will assess filgotinib’s ability to help adults with moderate to severe AS. Researchers will randomize about 100 patients to receive either 200 mg of oral filgotinib tablets or a placebo once a day for 12 weeks. Patients will be part of the study for a maximum of 20 weeks, from screening to follow-up. The trial is recruiting participants.

The study’s primary goal is to compare filgotinib’s impact, versus a placebo’s, on signs and symptoms of AS. The assessment tool will be patients’ ankylosing spondylitis disease activity scores (ASDAS) at week 12.

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