Spondyloarthritis & psoriatic arthritis
Targeting axial and peripheral psoriatic arthritis: a retrospective observational study on the clinical relevance of upadacitinib
Authors' conclusion
Our study confirms UPA effectiveness across PsA domains, with clinically meaningful improvements in axial involvement and pain.
Study context
- Population
- PsA patients treated with upadacitinib (UPA), 27 Italian rheumatology centres
- Participants
- 425 patients
- Exposure
- Peripheral PsA vs Mixed PsA
- Peripheral PsAn = 282
- Mixed PsAn = 143
- Outcome
- Proportion achieving ASDAS-LDA and ASDAS-ID (axial) and MDA and DAPSA remission/low disease activity (LDA) (peripheral)
- Follow-up
- 12 months
Methodological detailsmulticentre, observational
- Multicentre
- Observational
Main finding
As reported in the abstract
Axial and peripheral response to UPA
- ASDAS-LDA
- 38.2%
- ASDAS-ID
- 20.6%
- ASDAS-LDA, LUNDEX-adjusted
- 29.4%
- ASDAS-ID, LUNDEX-adjusted
- 15.8%
- MDA, crude
- 59.9%
- MDA, LUNDEX-adjusted
- 47.4%
Observational data: associations, not effects.
Further findings
Predictor of discontinuation: FM
| aHR (95% CI) | P value | ||
|---|---|---|---|
| FMStrongest predictor | 1.72 (1.08–2.75) | P = 0.022 | |
| 0.20.5125Adjusted hazard ratio (log scale) |
UPA survival (treatment persistence) · 12 months
- Overall survival rate
- 75.1%
- Higher in peripheral than mixed PsA
- P = 0.039
Enthesitis resolution
- Enthesitis resolved
- 80.2%
- P
- P < 0.001
NSAID use
- Decreased to
- 32.9%
- P
- P < 0.001
VAS pain
- Baseline to follow-up
- 71.4 to 40
- Mean change
- −31.4 (95% CI: −42.5 to −33.6; P < 0.0001)
- Reduction
- 44%
- Well above the minimal clinically important improvement
Safety
Adverse events (most mild)
- Gastrointestinal intolerance
- 19%
- Infections
- 9.5%
- Elevated liver enzymes
- 14.2%
- Major cardiovascular events
- 0
Original publication
Targeting axial and peripheral psoriatic arthritis: a retrospective observational study on the clinical relevance of upadacitinib. Rheumatology (Oxford). Published 4 August 2025. doi:10.
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