Persistence and effectiveness of upadacitinib and tumour necrosis factor inhibitors (TNFi) for rheumatoid arthritis using pooled data from Canadian and Swiss registries
Main finding · Treatment discontinuationResult — go to the resultHazard ratio 0.602 95% CI 0.469–0.773Authors' conclusion
Canadian and Swiss patients with RA had longer persistence with upadacitinib than TNFi, independent of previous advanced treatments.
Study context
- Population
- Patients with rheumatoid arthritis (RA) initiating upadacitinib or TNFi, 1 January 2020–30 June 2023, two Canadian registries and the Swiss SCQM registryCanadian and Swiss registries
- Participants
- 990 patients
- Exposure
- Upadacitinib vs TNFi
- Outcome
- Treatment persistence (risk of discontinuation)
Methodological detailsmulti-registry (RHUMADATA, OBRI, SCQM), propensity-score adjusted, multiple imputation, Persistence by Kaplan-Meier and Cox models; 174 RHUMADATA, 216 OBRI, 600 SCQM patients
- Multi-registry (RHUMADATA, OBRI, SCQM)
- Propensity-score adjusted
- Multiple imputation
- Persistence by Kaplan-Meier and Cox models; 174 RHUMADATA, 216 OBRI, 600 SCQM patients
Main finding
Treatment discontinuation
Hazard ratio
0.602
95% CI 0.469–0.773
Upadacitinibvs TNFi
HR 0.602 (95% CI 0.469–0.773)
As reported in the abstract
Observational data: associations, not effects.
Further findings
Discontinuation with concomitant any csDMARD, by treatment
| HR (95% CI) | ||
|---|---|---|
| Upadacitinib with csDMARDAssociated with improved persistence | 0.225 (0.107–0.471) | |
| TNFi with csDMARDAssociated with improved persistence | 0.516 (0.303–0.881) | |
| 0.10.31310Hazard ratio (log scale) |
Discontinuation with concomitant MTX, by treatment
| HR (95% CI) | ||
|---|---|---|
| Upadacitinib with MTXAssociated with improved persistence | 0.604 (0.390–0.934) | |
| TNFi with MTXAssociated with improved persistence | 0.694 (0.522–0.925) | |
| 0.20.5125Hazard ratio (log scale) |
CDAI low disease activity or remission · 6 months · observed (non-imputed) data
P = 0.1541
CDAI low disease activity or remission · 12 months · observed (non-imputed) data
P = 0.4494
Original publication
Persistence and effectiveness of upadacitinib and TNFi for rheumatoid arthritis using pooled data from Canadian and Swiss registries. Rheumatology (Oxford). Published 23 June 2026. doi:10.
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