Analysis Gauges Pain Relief With Upadacitinib in PsA, AS
Upadacitinib provided “rapid and sustained pain outcomes across several end points” among patients with active psoriatic arthritis (PsA) or ankylosing spondylitis (AS) in 3 randomized clinical trials, researchers reported.
Patients who participated in the SELECT-PsA 1 and SELECT-PsA 2 trials of upadacitinib for PsA and the SELECT-AXIS 1 for AS were randomized to upadacitinib 15 mg once daily or placebo. In the SELECT-PsA I some patients were randomized to receive adalimumab 40 mg every other week.
Among the outcomes of these trials was the proportion of patients achieving pain reduction of ≥30%, ≥50%, and ≥70% from baseline according to patient global assessments of pain.
“A higher proportion of patients receiving upadacitinib versus placebo achieved ≥30%, ≥50% and ≥70% reduction in pain end points as early as week 2; these improvements with upadacitinib were generally sustained or increased through year 1 (PsA 1/2 studies: 64%/48%, 58%/42% and 38%/22%, respectively; SELECT-AXIS 1 study: 76%, 72% and 54%),” the authors wrote. In the SELECT-PsA 1 trial patients treated with adalimumab reported similar levels of pain relief (59%, 49% and 32%).
“Patients who switched from placebo to upadacitinib 15 mg were able to reach a similar level of improvement as the continuous upadacitinib groups by year 1 (PsA 1/2 studies: 46%–60%, 35%–49% and 15%–34%; AS study: 83%, 72% and 46%),” the investigators noted.
These improvements in pain relief with upadacitinib were consistent over 1 year among patients with active PsA who had not achieved adequate response to prior nonbiologic or biologic disease-modifying antirheumatic drugs, and among patients with AS who had shown inadequate response to nonsteroidal anti-inflammatory drugs.
—Rebecca Mashaw
Reference:
McInnes IB, Ostor AJK, Mease PJ, et al. Effect of upadacitinib on reducing pain in patients with active psoriatic arthritis or ankylosing spondylitis: post hoc analysis of three randomised clinical trials. RMD Open. 2022; 8:e002049.
