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Posted by on Dec 30, 2019 in Rheumatoid Arthritis | 0 comments

In a nutshell

This study investigated patient-reported outcomes (PROs) in patients taking upadacitinib (Rinvoq) to treat rheumatoid arthritis (RA). They found that this treatment improved the quality of life (QoL) in these patients.

Some background

Rheumatoid arthritis (RA) is a chronic condition. In RA, the immune system attacks healthy joint tissue. This leads to painful swelling and tissue loss. Over time this can cause disability. RA is treated with disease-modifying anti-rheumatic drugs (DMARDs). There are many different DMARDs. Over time, patients may not respond to their DMARD regimen. It is unclear why this happens. New drugs are in development for RA. 

Upadacitinib (UPD) is a new DMARD. It targets a type of enzyme called Janus kinases (JAKs). JAKs are important immune enzymes. They are part of a signaling pathway that stimulates immune cells. In RA, the overstimulation of immune cells leads to excess inflammation. UPD has been shown to improve RA symptoms. UPD reduces RA disease activity (DA). There are other important aspects of RA. Patient-reported outcomes (PROs) are one of these. Quality of life (QoL) is a PRO. It is unclear if UPD improves PROs in patients with RA. 

Methods & findings

This study included 498 patients with moderate-severe RA. Patients were randomly assigned to treatment with UPD or placebo (inactive drug). UPD was administered at either 15 or 30 mg orally, once daily. PROs were assessed using a series of questionnaires. These measured health-related QoL (HRQoL) and disease burden (DB). Physical and mental health questionnaires assessed HRQoL and DB. Treatment lasted 12 weeks.

Scores in pain and disability were improved after treatment with UPD. Morning stiffness in the joints was reduced by 43% (15 mg) and 58% (30 mg) in UPD-treated patients. This compares to 11% reduction in placebo patients. Improvements in physical and emotional health, bodily pain and general function were observed in UPD-treated patients.

The bottom line

The authors concluded that upadacitinib improved QoL in patients with RA that did not respond to DMARDs.

The fine print

This was a short-term study. The long-term effects of QoL have not been investigated. The patients in this study were not responding to other biological DMARDs. It is unclear if all RA patients would have the same benefits in PROs from UPD treatment.

What’s next?

If you have any concerns regarding RA please discuss this with your doctor. 

Published By :

Arthritis Research & Therapy

Date :

Dec 02, 2019

Original Title :

Effects of upadacitinib on patient-reported outcomes: results from SELECT-BEYOND, a phase 3 randomized trial in patients with rheumatoid arthritis and inadequate responses to biologic disease-modifying antirheumatic drugs.

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