Categories
Change Password!
Reset Password!
Upadacitinib 15 mg achieves rapid (week 1) and sustained (104-week) ≥30–70% pain reduction in axial spondyloarthritis, with early response predicting long-term remission.
In a significant advance for axial spondyloarthritis (axSpA) management, a post-hoc analysis of the phase 2/3 SELECT-AXIS trials reveals that upadacitinib (UPA) 15 mg, a selective Janus kinase (JAK) inhibitor, delivers rapid, clinically meaningful pain relief within 1 week and maintains benefits through 104 weeks (2 years).
The analysis included adults with radiographic axSpA (r-axSpA/ankylosing spondylitis) and non-radiographic axSpA (nr-axSpA), including those naïve to or with inadequate response to biologic disease-modifying antirheumatic drugs (bDMARD-IR). Volunteers were randomized to UPA 15 mg once daily or placebo, with placebo crossover at week 14 (r-axSpA) and week 52 (nr-axSpA). Pain outcomes were rigorously assessed using nonresponder imputation and mixed-model repeated measures through week 104.
Results showed that UPA 15 mg remarkably outperformed placebo, with a higher proportion of patients achieving ≥30%, ≥50%, and ≥70% reduction in patient global pain scores as early as week 1. These improvements were sustained over 2 years in continuous treatment groups. Patients who switched from placebo to UPA illustrated comparable long-term pain reduction, reinforcing treatment consistency. Additional endpoints, including total back pain and minimal clinically important difference, further supported robust efficiency.
Notably, early pain response emerged as a strong predictor of long-term outcomes. Patients achieving ≥30% pain reduction at week 2 or ≥50% at week 14 were more likely to reach stringent disease targets at week 104, including Assessment of SpondyloArthritis International Society (ASAS) partial remission, Ankylosing Spondylitis Disease Activity Score (ASDAS) low disease activity, and ASDAS inactive disease. These findings underscore the role of UPA 15 mg as an effective long-term therapy for chronic inflammatory back pain in axSpA, particularly in those with prior bDMARD inadequate response, highlighting both rapid onset of action and durable disease control.
Rheumatology and Therapy
Impact of Upadacitinib on Reducing Pain in Patients Across the Axial Spondyloarthritis Spectrum: A Post Hoc Analysis of the Phase 2/3 SELECT-AXIS Studies
Xenofon Baraliakos et al.
Comments (0)