In a post hoc analysis from the SELECT-PsA 1 trial, more patients with psoriatic arthritis (PsA) treated with 15mg of upadacitinib achieved minimal clinically important differences (MCID) than patients treated with adalimumab, and the Routine Assessment of Patient Index Data 3 (RAPID3) tool proved useful in assessing disease activity in PsA, according to a poster presented by Laura Coates, MBBS, at ACR Convergence on November 12.

“RAPID3 is a fast and convenient tool that can be used in clinical practice to evaluate disease activity,” Dr Coates said. “It has been shown to be applicable in multiple rheumatic diseases, including psoriatic arthritis. The objective of this analysis from the SELECT-1 trial was to evaluate the long-term effect of treatment with the JAK inhibitor upadacitinib vs adalimumab on RAPID3 scores through 56 weeks, as well as the association of RAPID3 with other disease measures used in PsA.”

RAPID3 disease activity index is calculated from 3 patient-reported measures: physical function, pain, and patient global assessment, she explained, and has been shown to correlate with other clinical composite measures of disease activity.

Patients in this trial had PsA and had shown inadequate response or intolerance to at least 1 nonbiologic DMARD. A total of 1,274 patients were included. They received either upadacitinib 15 or 30mg (n=425) once daily or adalimumab 40 every other week (n-428), or placebo (n=421). Placebo patients were switched to upadacitinib 15 or 30 at week 24.

“At baseline, RAPID3 scores across all the patient groups were comparable and most patients were in high disease activity,” Dr Coates stated.

Patients receiving upadacitinib showed greater improvement from baseline in RAPID3 vs adalimumab at all visits from week 16 to week 56 and better responses vs placebo at all assessments, Dr Coates reported. “Similarly, a higher proportion of patients treated with upadacitinib achieved minimal clinically important differences, an improvement of at least 3.8 in RAPID 3 scores, compared to those receiving adalimumab, from week 24 to week 56.” By week 56, approximately half of the patients receiving either therapy were in RAPID3 remission or low disease activity.

RAPID3 disease categories were strongly associated with Disease Activity in PsA (DAPSA) and minimal disease activity/very low disease activity status at week 56 across all treatment arms.

“Upadacitinib treatment resulted in greater improvements in RAPID3 and a higher proportion of patients achieving MCID compared to adalimumab by week 24,” Dr Ogdie concluded. “RAPID3 was strongly associated with other composite measures, suggesting that this tool can serve as a useful, convenient measure of disease activity in clinical practice.”

—Rebecca Mashaw

Reference:

Coates LC, Kavanaugh A, McDearmon-Blondell E, et al. Upadacitinib versus adalimumab on routine assessment of patient index data 3 (RAPID3) In patients with psoriatic arthritis. Presented at: American College of Rheumatology Convergence. November 12, 2022.