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Objective To evaluate fenebrutinib, an oral and highly selective noncovalent inhibitor of Bruton's tyrosine kinase (BTK), in patients with active rheumatoid arthritis (RA). Methods Patients with RA and an inadequate response to methotrexate (MTX) (cohort 1; n = 480) were randomized to receive fenebrutinib (50 mg once daily, 150 mg once daily, or 200 mg twice daily), adalimumab (40 mg every other week), or placebo. Patients with RA and an inadequate response to tumor necrosis factor inhibitors (cohort 2; n = 98) received fenebrutinib (200 mg twice daily) or placebo. Both cohorts continued MTX therapy. Results In cohort 1, the percentages of patients in whom American College of Rheumatology 50% improvement criteria (ACR50) was achieved at week 12 were similar in the fenebrutinib 50 mg once daily and placebo groups, and were higher in the fenebrutinib 150 mg once daily group (28%) and 200 mg twice daily group (35%) than in the placebo group (15%) (P = 0.016 and P = 0.0003, respectively). Fenebrutinib 200 mg twice daily and adalimumab (36%) were comparable (P = 0.81). In cohort 2, ACR50 was achieved in more patients receiving fenebrutinib 200 mg twice daily (25%) than placebo (12%) (P = 0.072). The most common adverse events in the fenebrutinib groups included nausea, headache, anemia, and upper respiratory tract infections. Fenebrutinib had significant effects on myeloid and B cell biomarkers (CCL4 and rheumatoid factor). Fenebrutinib and adalimumab caused overlapping as well as distinct changes in B cell and myeloid biomarkers. Conclusion Fenebrutinib demonstrates efficacy comparable to adalimumab in patients with an inadequate response to MTX, and safety consistent with existing immunomodulatory therapies for RA. These data support targeting both B and myeloid cells via this novel mechanism for potential efficacy in the treatment of RA.

Rapid worldwide spread and polyphagous nature of the spotted wing Drosophila Drosophila suzukii Matsumura (Diptera: Drosophilidae) calls for efficient and selective control strategies to prevent severe economic losses in various fruit crops. The use of insecticides is one option for management of this invasive pest insect. Efficacy of insecticides is usually assessed first in laboratory bioassays, which are compounded by the cryptic nature of D. suzukii larvae and the fact that fruits used in bioassays often start to rot and dissolve before larvae have reached the adult stage. Here, we report on laboratory bioassays using three different types of substrates allowing a thorough screening of insecticides for their potential effects against D. suzukii eggs, larvae and adults. Suitability of our bioassays was validated in an assessment of the efficacy of four bioinsecticides and one synthetic insecticide against various developmental stages of D. suzukii. Water-apple juice agar used as a bioassay substrate allowed egg counting and observation of larval development due to its transparency, while apple-nutrition medium allowed complete metamorphosis. Use of grape berries in bioassays made it possible to assess effects of an insecticide present on a fruit’s surface on oviposition and larval hatch from eggs. Insecticides tested in these three different bioassays with acetamiprid, spinosad or natural pyrethrins as active ingredients achieved a significant D. suzukii control if they were applied before egg deposition. Number of adult flies was significantly reduced if the bioassay medium was treated with an azadirachtin A containing insecticide both before or after egg deposition.