Spondyloarthritis & psoriatic arthritis
Upadacitinib effectiveness and factors associated with minimal disease activity achievement in patients with psoriatic arthritis: preliminary data of a real-life multicenter study
Authors' conclusion
This is one of the first real-life studies supporting the effectiveness of UPA and its safety profile in PsA patients. Furthermore, the study identifies predictors of MDA response to UPA treatment at 6 months.
Study context
- Population
- Patients with psoriatic arthritis (PsA) treated with upadacitinib (UPA) in 10 Italian centres; 98% peripheral and 43% axial involvement; 87% intolerant or resistant to bDMARDs
- Participants
- 126 patients10 Italian centres
- Outcome
- UPA effectiveness: proportion with MDA status (also DAPSA remission and low disease activity, ASDAS-CRP inactive and low disease activity, change in DAPSA and ASDAS-CRP)
- Follow-up
- Week 24
Methodological detailsreal-life, multicentre, post-approval, preliminary data
- Real-life
- Multicentre
- Post-approval
- Preliminary data
Main finding
As reported in the abstract
MDA status achieved
47%
DAPSA remission achieved
23%
ASDAS-CRP inactive disease achieved
48%
Observational data: associations, not effects.
Further findings
DAPSA minor, moderate and major improvement · 24 weeks
- Minor DAPSA improvement
- 67%
- Moderate DAPSA improvement
- 39%
- Major DAPSA improvement
- 23%
ASDAS-CRP clinically important improvement (CII) and major improvement (MI) · 24 weeks
- ASDAS-CRP CII achieved
- 65%
- ASDAS-CRP MI achieved
- 35%
Mean change from baseline in DAPSA and ASDAS-CRP · 24 weeks
- Mean change from baseline, DAPSA
- 15.9 ± 13.5 (p < 0.001)
- Mean change from baseline, ASDAS-CRP
- 1.21 ± 0.97 (p < 0.001)
Factors associated with MDA response (multivariate analysis) · week 24
- Male gender
- OR 2.54, 95% CI 1.03-6.25 p = 0.043
- Naïve to biological DMARDs
- OR 4.13, 95% CI 1.34-12.71, p = 0.013
- Elevated baseline CRP
- OR 2.49, 95% CI 1.02-6.12, p = 0.046
Safety
Discontinuation of UPA due to lack of efficacy or non-serious adverse events
- Patients discontinuing UPA
- 13 (10%)
Serious adverse events
- No serious adverse events were observed
Original publication
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