Favorable benefit-risk ratio of upadacitinib compared to adalimumab for managing moderate-to severe RA

The findings of a post-hoc analysis conducted using the data from the SELECT-COMPARE trial have shown that the treatment using upadacitinib (UPA) has helped in achieving incremental clinical outcomes compared to adalimumab for managing moderate-to-severe RA.

The benefit-risk assessment was carried out among a hypothetical cohort of 100 patients. The study has shown that UPA showed greater efficacy compared to ADA in attaining clinical and functional improvements at 26, 48, and 156 weeks. Moreover, the safety profile of UPA is comparable to that of ADA.

UPA, a selective and reversible JAK inhibitor, acts by inhibiting the signaling by JAK1 or JAK1/3 with functional selectivity over cytokine receptors. Global regulatory agencies have approved UPA oral 15 mg once daily for managing moderate-to-severe RA in patients with inadequate response or intolerance to methotrexate.

The findings of the direct head-to-head trial, SELECTCOMPARE, have shown that the UPA treatment was associated with improvement in American College of Rheumatology score, pain, and physical function, and a greater proportion of subjects achieving remission. UPA showed greater efficacy over ADA as evidenced by number needed to treat (NNT) values <10 for attaining clinical remission and low disease
activity over 26 weeks.

The present study corroborates the efficacy and safety of UPA in managing active RA in subjects receiving background MTX.