Effect of upadacitinib on reducing pain in patients with active psoriatic arthritis or ankylosing spondylitis: post hoc analysis of three randomised clinical trials

McInnes, I. B. et al. (2022) Effect of upadacitinib on reducing pain in patients with active psoriatic arthritis or ankylosing spondylitis: post hoc analysis of three randomised clinical trials. RMD Open, 8(1), e002049. (doi: 10.1136/rmdopen-2021-002049) (PMID:35332058) (PMCID:PMC8948377)

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Abstract

Objective: Evaluate the effect of upadacitinib on pain outcomes in patients with active psoriatic arthritis (PsA) or ankylosing spondylitis (AS) across 3 randomised trials (SELECT-PsA 1 and 2 for PsA; SELECT-AXIS 1 for AS). Methods: Patients were randomised to upadacitinib 15 mg once daily or placebo (all 3 studies), or adalimumab 40 mg every other week (SELECT-PsA 1 only). Pain outcomes included proportion of patients achieving ≥30%, ≥50% and ≥70% reduction from baseline in patient global assessment of pain and other end points. Results: A higher proportion of patients receiving upadacitinib versus placebo achieved ≥30%, ≥50% and ≥70% reduction in pain end points as early as week 2; these improvements with upadacitinib were generally sustained or increased through year 1 (PsA 1/2 studies: 64%/48%, 58%/42% and 38%/22%, respectively; SELECT-AXIS 1 study: 76%, 72% and 54%). Results were similar with adalimumab in PsA 1 (59%, 49% and 32%). Patients who switched from placebo to upadacitinib 15 mg were able to reach a similar level of improvement as the continuous upadacitinib groups by year 1 (PsA 1/2 studies: 46%–60%, 35%–49% and 15%–34%; AS study: 83%, 72% and 46%). Results were similar with other pain end points. Conclusion: Rapid and sustained improvements in pain outcomes across several end points were consistently shown with upadacitinib over 1 year in patients with active PsA or AS who had either inadequate response to prior non-biologic or biologic disease-modifying antirheumatic drugs (PsA studies) or were biologic-naïve with inadequate response to non-steroidal anti-inflammatory drugs (AS study).

Item Type:Articles
Additional Information:AbbVie funded these studies and participated in the study designs, research, analyses, data collection, interpretation of data, reviewing and approval of the manuscript.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McInnes, Professor Iain
Authors: McInnes, I. B., Ostor, A. J.K., Mease, P. J., Tillett, W., Baraliakos, X., de Vlam, K., Bessette, L., Lippe, R., Maniccia, A., Feng, D., Gao, T., Zueger, P., Saffore, C., Kato, K., Song, I.-H., and Deodhar, A.
College/School:College of Medical Veterinary and Life Sciences > School of Infection & Immunity
Research Centre:College of Medical Veterinary and Life Sciences > School of Infection & Immunity > Centre for Immunobiology
Journal Name:RMD Open
Publisher:BMJ Publishing Group
ISSN:2056-5933
ISSN (Online):2056-5933
Published Online:24 March 2022
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in RMD Open 8(1): e002049
Publisher Policy:Reproduced under a Creative Commons License

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