Clinical Edge Journal Scan

PsA: Upadacitinib shows similar benefits as monotherapy or in combination with nbDMARDs


 

Key clinical point: Upadacitinib showed similar efficacy and a consistent safety profile as monotherapy or in combination with nonbiologic disease-modifying antirheumatic drugs (nbDMARDs) in patients with psoriatic arthritis (PsA).

Major finding: At week 12, ≥20% improvement in the American College of Rheumatology score was achieved by a similar proportion of patients receiving 15 mg upadacitinib or 30 mg upadacitinib as monotherapy (15 mg: 33.7%; 95% CI, 24.4%-43.1%; 30 mg: 45.7%; 95% CI, 36.9%-54.5%) or combination therapy (15 mg: 34.0%; 95% CI, 27.9%-40.1%; 30 mg: 39.6%; 95% CI, 33.7%-45.5%). Adverse events were generally similar with monotherapy and combination therapy.

Study details: This is a pooled analysis of 2 phase 3 trials, SELECT-PsA 1 and SELECT-PsA 2 , including 1,916 patients with active PsA with an inadequate response to 1 nbDMARD/bDMARD who were randomly assigned to placebo, 15 mg upadacitinib, or 30 mg upadacitinib as monotherapy or in combination with ≤2 nbDMARDs for 24 weeks.

Disclosures: This work was supported by AbbVie. Six authors reported being employees and stockholders of AbbVie. The other authors reported ties with several sources including AbbVie.

Source: Nash P et al. Rheumatology (Oxford). 2021;keab905 (Dec 3). Doi: 10.1093/rheumatology/keab905 .

Recommended Reading

Upadacitinib improves PRO in PsA patients with inadequate response to non-bDMARD
Psoriatic Arthritis ICYMI
TNF-α inhibitor remains a promising therapy for nail psoriasis and concomitant PsA
Psoriatic Arthritis ICYMI
Guselkumab’s efficacy, safety confirmed in patients with psoriatic arthritis and prior TNFi exposure
Psoriatic Arthritis ICYMI
Clinical Edge Journal Scan Commentary: PsA December 2021
Psoriatic Arthritis ICYMI
Upadacitinib (Rinvoq) gains psoriatic arthritis as second FDA-approved indication
Psoriatic Arthritis ICYMI
New option for flares in pustular psoriasis
Psoriatic Arthritis ICYMI
Spesolimab speeds lesion clearance in generalized pustular psoriasis
Psoriatic Arthritis ICYMI
Case series show no consensus on treatment for palmoplantar pustulosis, generalized pustular psoriasis
Psoriatic Arthritis ICYMI
Proactive infliximab monitoring found best for sustaining control of inflammatory diseases
Psoriatic Arthritis ICYMI
Discontinuing TNF inhibitors may not be required in PsA patients receiving BNT162b2 SARS-CoV-2 vaccine
Psoriatic Arthritis ICYMI