Comparative Effectiveness of Upadacitinib vs. Other JAK Inhibitors in Patients With Rheumatoid Arthritis in a Global Real-World Setting.

IF 2.9 3区医学 Q2 RHEUMATOLOGY

Rheumatology and Therapy Pub Date : 2026-04-14 DOI:10.1007/s40744-026-00855-0

Peter C Taylor, Aditi Kadakia, Jack Milligan, Ana Romero, Oliver Howell, Pankaj A Patel, Sophie Barlow, Roberto Caporali

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Abstract

Introduction: This study aimed to compare the real-world effectiveness of upadacitinib vs. other Janus kinase inhibitors (JAKis) in patients with rheumatoid arthritis (RA).

Methods: Data were extracted from the Adelphi RA Disease Specific Programme™ (DSP), a cross-sectional survey administered to rheumatologists and their patients in the EU, UK, Japan, Canada, and the US from July 2021 to February 2022. Patients receiving upadacitinib 15 mg or other JAKis, including tofacitinib, baricitinib, or peficitinib, for ≥ 6 months were included in the study. Data captured at treatment initiation and follow-up (≥ 6 months) included physician-evaluated pain rating and Disease Activity Score in 28 joints (DAS28). Fatigue and medication adherence were recorded at follow-up only. Inverse-probability-weighted regression adjustment was used to compare clinical outcomes at follow-up between patients treated with upadacitinib vs. other JAKis.

Results: Of 1440 total patients with RA, 1205 patients received upadacitinib and 235 received other JAKis. At study initiation, the majority of patients in both treatment groups had moderate/high disease activity (upadacitinib: 63.5%, other JAKis: 51.3%). At the most recent follow-up, after adjusting for differences in clinical characteristics between groups, patients treated with upadacitinib were significantly more likely to have attained physician-reported remission (54.3% vs. 44.1%, P = 0.030), have no pain (43.4% vs. 32.8%, P = 0.016), and have complete medication adherence (59.5% vs. 49.0%, P = 0.025) compared with patients treated with other JAKis. Of patients treated with upadacitinib, 42.5% were reported as having no fatigue compared with 36.1% of patients receiving other JAKis (P = 0.173).

Conclusions: This real-world study of patients with RA showed that greater proportions of patients who received upadacitinib attained physician-reported DAS28 remission, absence of pain, and complete adherence to medication compared with patients receiving other JAKis.

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Upadacitinib与其他JAK抑制剂在全球风湿性关节炎患者中的疗效比较

本研究旨在比较upadacitinib与其他Janus激酶抑制剂（JAKis）在类风湿性关节炎（RA）患者中的实际疗效。方法：数据来自Adelphi RA疾病特异性计划™（DSP），这是一项横断面调查，于2021年7月至2022年2月对欧盟、英国、日本、加拿大和美国的风湿病学家及其患者进行调查。接受upadacitinib 15mg或其他JAKis治疗≥6个月的患者（包括tofacitinib、baricitinib或pecicitinib）被纳入研究。在治疗开始和随访（≥6个月）收集的数据包括28个关节的医生评估的疼痛评分和疾病活动评分（DAS28）。仅在随访时记录疲劳和药物依从性。采用逆概率加权回归调整来比较upadacitinib与其他JAKis治疗患者的随访临床结果。结果：1440例RA患者中，1205例患者接受了upadacitinib治疗，235例患者接受了其他JAKis治疗。在研究开始时，两个治疗组的大多数患者都有中度/高度疾病活动性（upadacitinib: 63.5%，其他JAKis: 51.3%）。在最近的随访中，在调整组间临床特征差异后，与其他JAKis治疗的患者相比，upadacitinib治疗的患者更有可能达到医生报告的缓解（54.3% vs. 44.1%, P = 0.030），没有疼痛（43.4% vs. 32.8%, P = 0.016），并且完全遵守药物治疗（59.5% vs. 49.0%, P = 0.025）。在接受upadacitinib治疗的患者中，42.5%的患者报告无疲劳，而接受其他JAKis治疗的患者为36.1% （P = 0.173）。结论：这项对RA患者的真实世界研究表明，与接受其他JAKis的患者相比，接受upadacitinib的患者获得医生报告的DAS28缓解，无疼痛和完全依从性的比例更高。

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来源期刊

Rheumatology and Therapy RHEUMATOLOGY-

CiteScore

6.00

自引率

5.30%

发文量

审稿时长

6 weeks

期刊介绍： Aims and Scope Rheumatology and Therapy is an international, open access, peer reviewed, rapid publication journal dedicated to the publication of high-quality clinical (all phases), observational, real-world and health outcomes research around the discovery, development, and use of rheumatologic therapies. Studies relating to diagnosis, pharmacoeconomics, public health, quality of life, and patient care, management, and education are also welcomed. Areas of focus include, but are not limited to, rheumatoid arthritis, gout, gouty arthritis, psoriatic arthritis, osteoarthritis, juvenile idiopathic/rheumatoid arthritis, systemic lupus erythematosus, axial spondyloarthritis, Pompe’s disease, inflammatory joint conditions, musculoskeletal conditions, systemic sclerosis, and fibromyalgia. The journal is of interest to a broad audience of healthcare professionals and publishes original research, reviews, case reports, trial protocols, communications and letters. The journal is read by a global audience and receives submissions from all over the world. Rheumatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an international and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of all scientifically and ethically sound research. Ethics and Disclosures The journal is a member of the Committee on Publication Ethics (COPE) and subscribes to its principles on how to deal with acts of misconduct thereby committing to investigate allegations of misconduct in order to ensure the integrity of research. Content in this journal is peer-reviewed (Single-blind). For more information on our publishing ethics policies, please see here: https://www.springer.com/gp/editorial-policies Rapid Publication The journal’s rapid publication timelines aim for a peer review decision within 2 weeks of submission. If an article is accepted it will be published online 3-4 weeks from acceptance. These rapid timelines are achieved through the combination of a dedicated in-house editorial team, who closely manage article workflow, and an extensive Editorial and Advisory Board who assist with rapid peer review. This allows the journal to support the rapid dissemination of research, whilst still providing robust peer review. Combined with the journal’s open access model this allows for the rapid and efficient communication of the latest research and reviews, allowing the advancement of rheumatologic therapies. 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