Publications

Burmester et al. provide insights into the benefit–risk profiles of UPA and adalimumab in patients with varying cardiovascular (CV) risks, suggesting that UPA may offer efficacy advantages over adalimumab irrespective of baseline CV risk, with generally similar rates of AEs. To better understand the benefits and risks of RA treatments in patients with different background CV risk, Burmester et al. assessed the short-term and long-term benefit–risk profiles of UPA and adalimumab in patients enrolled in SELECT-COMPARE.

The SELECT-MONOTHERAPY study evaluated the safety and efficacy of UPA monotherapy through 260 weeks of treatment, in patients with RA who had prior inadequate response to MTX. No new safety signals were observed with long-term exposure to UPA, and results were consistent with prior findings and the established safety profile of UPA across indications. These data support the potential of UPA as a treatment option for patients with moderate to severe active RA who have responded inadequately to MTX.

Poddubnyy et al. identified no apparent increase in the risk of developing extramusculoskeletal manifestations (EMMs) in patients with PsA, r-axSpA, and nr-axSpA receiving 15mg UPA in the SELECT trials. Majority of patients did not report a history of EMMs at baseline, regardless of disease indication or study treatment.

Kaya et al. reported that switching to secukinumab or cycling to another TNFi after first TNFi failure in axSpA led to comparable drug survival, with predictive factors differing by treatment. The study reports that smoking and Achilles enthesitis were associated with higher SEC discontinuation, while high CRP and primary TNFi failure predicted TNFi discontinuation.

Van den Bosch et al. reported that upadacitinib 15 mg once daily led to sustained improvement in nr-axSpA over two years, including disease activity, pain, and quality of life. The study reports that 57.1% achieved ASAS40 response at week 104, with no new safety signals identified.

Kanda et al. investigated the efficacy of second-line b/tsDMARDs in RA patients unresponsive to first-line b/tsDMARDs. Using data from the FIRST registry, the study assessed 687 patients with RA treated with TNFis, IL-6 receptor inhibitors, cytotoxic T-lymphocyte-associated protein 4 immunoglobulin, or JAKis. After propensity score-based adjustment, JAKi showed the highest persistence rate, greatest improvement in CDAI, and highest remission rates at 24 weeks. Among JAKi, UPA was most effective in achieving remission, with a safety profile comparable to other b/tsDMARDs.

Poddubnyy et al. analysed five clinical trials to evaluate extra-musculoskeletal manifestations (EMMs) like uveitis, IBD, and psoriasis in patients treated with UPA. They observed low incidences across PsA, r-axSpA, and nr-axSpA. Numerically, uveitis rates were lower in
UPA-treated patients than in those receiving placebo, particularly in r-axSpA.

Baraliakos et al. assessed the long-term efficacy and safety of upadacitinib in patients with active ankylosing spondylitis who were refractory to biologic therapy. At week 104, the treatment sustained improvements in disease activity and functional outcomes with low rates of radiographic progression and no new safety signals.