In a nutshell
This study investigated the safety and effectiveness of upadacitinib for the treatment of rheumatoid arthritis. They found that upadacitinib is a safe and effective treatment for RA.
Some background
Disease-modifying anti-rheumatic drugs (DMARDs) are one of the standard medications to treat rheumatoid arthritis (RA). Biological DMARDs, or bDMARDs, are highly effective in reducing RA disease symptoms. Some patients, however, do not respond well to bDMARDs or they may lose effectiveness over time.
Developing drugs with other mechanisms of action is necessary to improve treatment of RA patients that do not respond to conventional therapy. A new class of drugs that target Janus kinases (JAKs), can improve symptoms by blocking enzymes that cause inflammation. Upadacitinib is a drug that blocks the JAK1 enzyme.
It is unknown if upadacitinib is a safe and effective medication for the treatment of RA.
Methods & findings
This study investigated the safety and effectiveness of upadacitinib for the treatment of RA.
This study included 451 patients with RA and unresponsive to bDMARDs. Patients were randomly assigned to receive either 15mg upadacitinib, 30 mg upadacitinib or placebo (inactive tablet) for 12 weeks. After this period, patients received either 15 mg or 30 mg upadacitinib for up to 5 years (this study is ongoing). At the end of 12 weeks disease activity was measured.
At week 12, 65% of patients taking 15 mg upadacitinib and 56% of patients taking 30 mg of upadacitinib achieved a 20% improvement in disease symptoms, compared to 28% of placebo patients. 23% of patients taking 30 mg achieved a 70% improvement in symptoms, compared to 7% of placebo patients. More patients that received upadacitinib had improved disease activity (42-43% vs. 14% of placebo patients).
Patients taking either 15 mg upadacitinib or placebo reported a similar proportion of adverse events (56%). 67% of patients taking 30 mg upadacitinib reported adverse events. Infections were the most common event.
The bottom line
The authors concluded that upadacitinib is a safe and effective treatment for RA.
The fine print
Upadacitinib is a new drug under investigation and long-term safety and effectiveness is still to be determined.
What’s next?
If you have any concerns regarding treatment of rheumatoid arthritis, please consult with your physician.
Published By :
Lancet (London, England)
Date :
Jun 12, 2018
