Rates of MACE and VTE events in patients with RA or PsA treated are consistent across 15 mg and 30 mg doses of upadacitinib, and comparable with active comparators adalimumab and MTX. Several risk factors were also identified for MACE and VTE events in patients with RA.

Rates of malignancy were similar between upadacitinib, adalimumab, and MTX. They were also consistent across RA, PsA, AS and nr-axSpA. A dose-dependent increased rate of NMSC was observed with upadacitinib in RA. For RA and PsA, being older (≥65 years) and male was associated with
an increased risk of malignancy excluding NMSC.

June 2023

JAK Inhibitors and the Risk of Malignancy: A Meta-analysis Across Disease Indications

Ann Rheum Dis. 2023;82(8):1059–1067 doi: 10.1136/ard-2023-224049

The objective of this study was to estimate the association of JAKi with the incidence of malignancy, compared with placebo, TNFi and MTX.

Many RCTs have demonstrated efficacy and safety of biologics in PsA. However, long term comparative real world data is lacking. This study aimed to evaluate the real-world effectiveness and persistence of the IL-12/23 inhibitor ustekinumab or a TNFi for PsA 1 year post initiation. As a result, they found that PS-adjusted comparisons demonstrated comparable overall persistence, effectiveness and safety for both modes of action in PsA.