Achievement of treatment targets and maintenance of response with upadacitinib in patients with moderate-to-severe rheumatoid arthritis in real-world practice: 1-year outcomes from the UPHOLD observational study
Authors' conclusion
UPA demonstrated real-world effectiveness in moderate-to-severe RA, with approximately half of patients achieving DAS28(CRP) remission at 6 months and most maintaining remission through 12 months.
Study context
- Population
- Adults with moderate-to-severe rheumatoid arthritis (RA) in real-world practice1,717 enrolled
- Participants
- 1,719 adults
- Outcome
- Co-primary: proportion achieving DAS28(CRP) remission (< 2.6) at 6 months; proportion of those maintaining remission at 12 months
- Follow-up
- 6 months; 12 months
Methodological detailsreal-world, single-arm
- Real-world
- Single-arm
Main finding
As reported in the abstract
DAS28(CRP) remission at 6 months, modified non-responder imputation (mNRI) (mFAS1)
499 of 1074
46.5%
DAS28(CRP) remission at 6 months, as observed (AO)
499 of 902
55.3%
Remission maintained at 12 months, mNRI (mFAS2)
269 of 340
79.1%
Remission maintained at 12 months, AO
269 of 317
84.9%
Observational data: associations, not effects.
Secondary outcomes
DAS28(CRP) remission or low disease activity (LDA) by therapy strategy (monotherapy vs combination)
- Rates consistent regardless of whether upadacitinib (UPA) was initiated and maintained as monotherapy or combination therapy
Response by prior treatment subgroups
- Similar responses across prior treatment subgroups
Discontinuation before 12 months
- Discontinued before 12 months
- 400/1719 (23.3%)
Safety
Selected treatment-emergent adverse events (TEAEs) of special interest · through August 10, 2023
- Herpes zoster, events/100 patient-years
- 3.12
- Serious infection, events/100 patient-years
- 2.62
- No new safety signals were identified
Original publication
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