Upadacitinib Demonstrates Significant Improvement in Enthesitis in Psoriatic Arthritis Patients
A post hoc analysis of the SELECT-PsA Phase 3 trials evaluated the impact of upadacitinib (UPA15) on enthesitis in patients with psoriatic arthritis (PsA). The study published in Rheumatology compared the effects of UPA15 against placebo in patients who had an inadequate response or intolerance to 1 or more disease-modifying antirheumatic drugs (DMARDs).
Data from 639 patients receiving UPA15 and 635 patients receiving placebo were analyzed. Enthesitis was assessed using the leeds enthesitis index (LEI) and the spondyloarthritis research consortium of Canada (SPARCC) index. Results showed that UPA15 significantly outperformed placebo, with higher rates of enthesitis resolution at week 24. Specifically, 59.8% of UPA15-treated patients achieved enthesitis resolution according to the LEI, compared to 38.0% of placebo-treated patients. Similar results were seen using the SPARCC index (50.6% vs 31.5%).
Improvements in the LEI and SPARCC index continued through week 56, with UPA15 patients showing a reduction of -1.7 and -3.4, respectively, compared to -1.0 and -1.9 in the placebo group. Notably, over 90% of patients without enthesitis at baseline who received UPA15 remained enthesitis-free at week 56. UPA15 also effectively prevented recurrence of enthesitis, with more than 80% of patients achieving resolution at week 24 maintaining an enthesitis-free state at week 56.
“UPA15 is associated with a comprehensive improvement in enthesitis, with improvements observed after 12 weeks of treatment,” concluded the study authors. “Additionally, treatment with UPA15 was associated with maintaining an enthesitis-free state after resolution and protection against new-onset enthesitis.”
Reference
Cantini F, Marchesoni A, Novelli L, et al. Effects of upadacitinib on enthesitis in patients with psoriatic arthritis: a post hoc analysis of SELECT-PsA 1 and 2 trials. Rheumatology (Oxford). 2024;63(11):3146-3154. doi:10.1093/rheumatology/keae057
