Upadacitinib Versus Placebo or Adalimumab in Patients With Rheumatoid Arthritis and an Inadequate Response to Methotrexate: Results of a Phase III, Double‐Blind, Randomized Controlled Trial
Objective To evaluate the efficacy, including capacity for inhibition of radiographic progression, and safety of upadacitinib, a JAK1‐selective inhibitor, as compared to placebo or adalimumab in patients with rheumatoid arthritis (RA) who have experienced an inadequate response to methotrexate (MTX)...
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| Veröffentlicht in: | Arthritis & rheumatology (Hoboken, N.J.) N.J.), 2019-11, Vol.71 (11), p.1788-1800 |
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| creator | Fleischmann, Roy Pangan, Aileen L. Song, In‐Ho Mysler, Eduardo Bessette, Louis Peterfy, Charles Durez, Patrick Ostor, Andrew J. Li, Yihan Zhou, Yijie Othman, Ahmed A. Genovese, Mark C. |
| description | Objective
To evaluate the efficacy, including capacity for inhibition of radiographic progression, and safety of upadacitinib, a JAK1‐selective inhibitor, as compared to placebo or adalimumab in patients with rheumatoid arthritis (RA) who have experienced an inadequate response to methotrexate (MTX).
Methods
In total, 1,629 RA patients with an inadequate response to MTX were randomized (2:2:1) to receive upadacitinib (15 mg once daily), placebo, or adalimumab (40 mg every other week) while continuing to take a stable background dose of MTX. The primary end points were achievement of an American College of Rheumatology 20% (ACR20) improvement response and a Disease Activity Score in 28 joints using C‐reactive protein level (DAS28‐CRP) of |
| doi_str_mv | 10.1002/art.41032 |
| format | Article |
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To evaluate the efficacy, including capacity for inhibition of radiographic progression, and safety of upadacitinib, a JAK1‐selective inhibitor, as compared to placebo or adalimumab in patients with rheumatoid arthritis (RA) who have experienced an inadequate response to methotrexate (MTX).
Methods
In total, 1,629 RA patients with an inadequate response to MTX were randomized (2:2:1) to receive upadacitinib (15 mg once daily), placebo, or adalimumab (40 mg every other week) while continuing to take a stable background dose of MTX. The primary end points were achievement of an American College of Rheumatology 20% (ACR20) improvement response and a Disease Activity Score in 28 joints using C‐reactive protein level (DAS28‐CRP) of <2.6 in the upadacitinib group compared to the placebo group at week 12; inhibition of radiographic progression was evaluated at week 26. The study was also designed and powered to test for the noninferiority and superiority of upadacitinib compared to adalimumab, as measured both clinically and functionally.
Results
At week 12, both primary end points were met in patients receiving upadacitinib compared to those receiving placebo (P ≤ 0.001). An ACR20 improvement response was achieved by 71% of patients in the upadacitinib group compared to 36% in the placebo group, and a DAS28‐CRP score of <2.6 was observed in 29% of patients receiving upadacitinib compared to 6% of patients receiving placebo. Upadacitinib was superior to adalimumab based on the ACR50 response rate, achievement of a DAS28‐CRP score of ≤3.2, change in pain severity score, and change in the Health Assessment Questionnaire disability index. At week 26, more patients receiving upadacitinib than those receiving placebo or adalimumab achieved low disease activity or remission (P ≤ 0.001). Radiographic progression was significantly inhibited in patients receiving upadacitinib and was observed in fewer upadacitinib‐treated patients than placebo‐treated patients (P ≤ 0.001). Up to week 26, adverse events (AEs), including serious infections, were comparable between the upadacitinib and adalimumab groups. The proportions of patients with serious AEs and AEs leading to discontinuation were highest in the adalimumab group; the proportions of patients with herpes zoster and those with creatine phosphokinase (CPK) elevations were highest in the upadacitinib group. Three malignancies, 5 major adverse cardiovascular events, and 4 deaths were reported among the groups, but none occurred in patients receiving upadacitinib. Six venous thromboembolic events were reported (1 in the placebo group, 2 in the upadacitinib group, and 3 in the adalimumab group).
Conclusion
Upadacitinib was superior to placebo and adalimumab for improving signs, symptoms, and physical function in RA patients who were receiving background MTX. In addition, radiographic progression was significantly inhibited by upadacitinib as compared to placebo. The overall safety profile of upadacitinib was generally similar to that of adalimumab, except for higher rates of herpes zoster and CPK elevations in patients receiving upadacitinib.</description><identifier>ISSN: 2326-5191</identifier><identifier>EISSN: 2326-5205</identifier><identifier>DOI: 10.1002/art.41032</identifier><identifier>PMID: 31287230</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adalimumab - therapeutic use ; Adult ; Aged ; Antirheumatic Agents - therapeutic use ; Arthritis ; Arthritis, Rheumatoid - diagnostic imaging ; Arthritis, Rheumatoid - drug therapy ; Arthritis, Rheumatoid - physiopathology ; Creatine ; Creatine kinase ; Creatine Kinase - metabolism ; Double-Blind Method ; Double-blind studies ; Drug Therapy, Combination ; Evaluation ; Female ; Health risk assessment ; Herpes zoster ; Herpes Zoster - epidemiology ; Heterocyclic Compounds, 3-Ring - therapeutic use ; Humans ; Immunotherapy ; Infections - epidemiology ; Janus kinase ; Janus Kinase Inhibitors - therapeutic use ; Joint diseases ; Male ; Methotrexate ; Methotrexate - therapeutic use ; Middle Aged ; Monoclonal antibodies ; Pain ; Randomization ; Remission ; Rheumatoid arthritis ; Safety ; Severity of Illness Index ; Signs and symptoms ; Thromboembolism ; TNF inhibitors ; Venous Thromboembolism - epidemiology</subject><ispartof>Arthritis & rheumatology (Hoboken, N.J.), 2019-11, Vol.71 (11), p.1788-1800</ispartof><rights>2019, American College of Rheumatology</rights><rights>2019, American College of Rheumatology.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3532-3e778d6d8c82ced09c7b9b1e35c7d157a7a9b1da0997a0d3e4bddbf48d77f72f3</citedby><cites>FETCH-LOGICAL-c3532-3e778d6d8c82ced09c7b9b1e35c7d157a7a9b1da0997a0d3e4bddbf48d77f72f3</cites><orcidid>0000-0002-4937-2775 ; 0000-0002-6630-1477 ; 0000-0001-5294-4503</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fart.41032$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fart.41032$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1416,27922,27923,45572,45573</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31287230$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fleischmann, Roy</creatorcontrib><creatorcontrib>Pangan, Aileen L.</creatorcontrib><creatorcontrib>Song, In‐Ho</creatorcontrib><creatorcontrib>Mysler, Eduardo</creatorcontrib><creatorcontrib>Bessette, Louis</creatorcontrib><creatorcontrib>Peterfy, Charles</creatorcontrib><creatorcontrib>Durez, Patrick</creatorcontrib><creatorcontrib>Ostor, Andrew J.</creatorcontrib><creatorcontrib>Li, Yihan</creatorcontrib><creatorcontrib>Zhou, Yijie</creatorcontrib><creatorcontrib>Othman, Ahmed A.</creatorcontrib><creatorcontrib>Genovese, Mark C.</creatorcontrib><title>Upadacitinib Versus Placebo or Adalimumab in Patients With Rheumatoid Arthritis and an Inadequate Response to Methotrexate: Results of a Phase III, Double‐Blind, Randomized Controlled Trial</title><title>Arthritis & rheumatology (Hoboken, N.J.)</title><addtitle>Arthritis Rheumatol</addtitle><description>Objective
To evaluate the efficacy, including capacity for inhibition of radiographic progression, and safety of upadacitinib, a JAK1‐selective inhibitor, as compared to placebo or adalimumab in patients with rheumatoid arthritis (RA) who have experienced an inadequate response to methotrexate (MTX).
Methods
In total, 1,629 RA patients with an inadequate response to MTX were randomized (2:2:1) to receive upadacitinib (15 mg once daily), placebo, or adalimumab (40 mg every other week) while continuing to take a stable background dose of MTX. The primary end points were achievement of an American College of Rheumatology 20% (ACR20) improvement response and a Disease Activity Score in 28 joints using C‐reactive protein level (DAS28‐CRP) of <2.6 in the upadacitinib group compared to the placebo group at week 12; inhibition of radiographic progression was evaluated at week 26. The study was also designed and powered to test for the noninferiority and superiority of upadacitinib compared to adalimumab, as measured both clinically and functionally.
Results
At week 12, both primary end points were met in patients receiving upadacitinib compared to those receiving placebo (P ≤ 0.001). An ACR20 improvement response was achieved by 71% of patients in the upadacitinib group compared to 36% in the placebo group, and a DAS28‐CRP score of <2.6 was observed in 29% of patients receiving upadacitinib compared to 6% of patients receiving placebo. Upadacitinib was superior to adalimumab based on the ACR50 response rate, achievement of a DAS28‐CRP score of ≤3.2, change in pain severity score, and change in the Health Assessment Questionnaire disability index. At week 26, more patients receiving upadacitinib than those receiving placebo or adalimumab achieved low disease activity or remission (P ≤ 0.001). Radiographic progression was significantly inhibited in patients receiving upadacitinib and was observed in fewer upadacitinib‐treated patients than placebo‐treated patients (P ≤ 0.001). Up to week 26, adverse events (AEs), including serious infections, were comparable between the upadacitinib and adalimumab groups. The proportions of patients with serious AEs and AEs leading to discontinuation were highest in the adalimumab group; the proportions of patients with herpes zoster and those with creatine phosphokinase (CPK) elevations were highest in the upadacitinib group. Three malignancies, 5 major adverse cardiovascular events, and 4 deaths were reported among the groups, but none occurred in patients receiving upadacitinib. Six venous thromboembolic events were reported (1 in the placebo group, 2 in the upadacitinib group, and 3 in the adalimumab group).
Conclusion
Upadacitinib was superior to placebo and adalimumab for improving signs, symptoms, and physical function in RA patients who were receiving background MTX. In addition, radiographic progression was significantly inhibited by upadacitinib as compared to placebo. The overall safety profile of upadacitinib was generally similar to that of adalimumab, except for higher rates of herpes zoster and CPK elevations in patients receiving upadacitinib.</description><subject>Adalimumab - therapeutic use</subject><subject>Adult</subject><subject>Aged</subject><subject>Antirheumatic Agents - therapeutic use</subject><subject>Arthritis</subject><subject>Arthritis, Rheumatoid - diagnostic imaging</subject><subject>Arthritis, Rheumatoid - drug therapy</subject><subject>Arthritis, Rheumatoid - physiopathology</subject><subject>Creatine</subject><subject>Creatine kinase</subject><subject>Creatine Kinase - metabolism</subject><subject>Double-Blind Method</subject><subject>Double-blind studies</subject><subject>Drug Therapy, Combination</subject><subject>Evaluation</subject><subject>Female</subject><subject>Health risk assessment</subject><subject>Herpes zoster</subject><subject>Herpes Zoster - epidemiology</subject><subject>Heterocyclic Compounds, 3-Ring - therapeutic use</subject><subject>Humans</subject><subject>Immunotherapy</subject><subject>Infections - epidemiology</subject><subject>Janus kinase</subject><subject>Janus Kinase Inhibitors - therapeutic use</subject><subject>Joint diseases</subject><subject>Male</subject><subject>Methotrexate</subject><subject>Methotrexate - therapeutic use</subject><subject>Middle Aged</subject><subject>Monoclonal antibodies</subject><subject>Pain</subject><subject>Randomization</subject><subject>Remission</subject><subject>Rheumatoid arthritis</subject><subject>Safety</subject><subject>Severity of Illness Index</subject><subject>Signs and symptoms</subject><subject>Thromboembolism</subject><subject>TNF inhibitors</subject><subject>Venous Thromboembolism - epidemiology</subject><issn>2326-5191</issn><issn>2326-5205</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kd1qFDEYhgdRbKk98AYk4IlCt83PZDPj2Xb9G6i4LFs9HL6ZfMOmZJJtkkHrkZfgHXkvXomp23ogGAj5wvvwEPIWxVNGTxml_AxCOi0ZFfxBccgFn88kp_Lh_cxqdlAcx3hF86oVnVP5uDgQjFeKC3pY_LzcgYbeJONMRz5hiFMkKws9dp74QBYarBmnETpiHFlBMuhSJJ9N2pL1FnOQvNFkEdI2ZEkk4HTepHGg8XqChGSNceddRJI8-YBp61PArzl4dZtMNtv8QICstpCZpmlOyGs_dRZ_ff9xbo3TJ2SdpX4031CTpXcpeGvzuAkG7JPi0QA24vHdeVRcvn2zWb6fXXx81ywXF7NeSMFnApWq9FxXfcV71LTuVVd3DIXslWZSgYJ81UDrWgHVAstO624oK63UoPggjooXe-8u-OsJY2pHE3u0Fhz6Kbacy1IyVZcqo8__Qa_8FFx-XZu_vJa0UnOZqZd7qg8-xoBDuwtmhHDTMtreFtvmYts_xWb22Z1x6kbUf8n7GjNwtge-GIs3_ze1i_Vmr_wN3A-v9w</recordid><startdate>201911</startdate><enddate>201911</enddate><creator>Fleischmann, Roy</creator><creator>Pangan, Aileen L.</creator><creator>Song, In‐Ho</creator><creator>Mysler, Eduardo</creator><creator>Bessette, Louis</creator><creator>Peterfy, Charles</creator><creator>Durez, Patrick</creator><creator>Ostor, Andrew J.</creator><creator>Li, Yihan</creator><creator>Zhou, Yijie</creator><creator>Othman, Ahmed A.</creator><creator>Genovese, Mark C.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QL</scope><scope>7QP</scope><scope>7T5</scope><scope>7TM</scope><scope>7U7</scope><scope>C1K</scope><scope>H94</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4937-2775</orcidid><orcidid>https://orcid.org/0000-0002-6630-1477</orcidid><orcidid>https://orcid.org/0000-0001-5294-4503</orcidid></search><sort><creationdate>201911</creationdate><title>Upadacitinib Versus Placebo or Adalimumab in Patients With Rheumatoid Arthritis and an Inadequate Response to Methotrexate: Results of a Phase III, Double‐Blind, Randomized Controlled Trial</title><author>Fleischmann, Roy ; Pangan, Aileen L. ; Song, In‐Ho ; Mysler, Eduardo ; Bessette, Louis ; Peterfy, Charles ; Durez, Patrick ; Ostor, Andrew J. ; Li, Yihan ; Zhou, Yijie ; Othman, Ahmed A. ; Genovese, Mark C.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3532-3e778d6d8c82ced09c7b9b1e35c7d157a7a9b1da0997a0d3e4bddbf48d77f72f3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adalimumab - therapeutic use</topic><topic>Adult</topic><topic>Aged</topic><topic>Antirheumatic Agents - therapeutic use</topic><topic>Arthritis</topic><topic>Arthritis, Rheumatoid - diagnostic imaging</topic><topic>Arthritis, Rheumatoid - drug therapy</topic><topic>Arthritis, Rheumatoid - physiopathology</topic><topic>Creatine</topic><topic>Creatine kinase</topic><topic>Creatine Kinase - metabolism</topic><topic>Double-Blind Method</topic><topic>Double-blind studies</topic><topic>Drug Therapy, Combination</topic><topic>Evaluation</topic><topic>Female</topic><topic>Health risk assessment</topic><topic>Herpes zoster</topic><topic>Herpes Zoster - epidemiology</topic><topic>Heterocyclic Compounds, 3-Ring - therapeutic use</topic><topic>Humans</topic><topic>Immunotherapy</topic><topic>Infections - epidemiology</topic><topic>Janus kinase</topic><topic>Janus Kinase Inhibitors - therapeutic use</topic><topic>Joint diseases</topic><topic>Male</topic><topic>Methotrexate</topic><topic>Methotrexate - therapeutic use</topic><topic>Middle Aged</topic><topic>Monoclonal antibodies</topic><topic>Pain</topic><topic>Randomization</topic><topic>Remission</topic><topic>Rheumatoid arthritis</topic><topic>Safety</topic><topic>Severity of Illness Index</topic><topic>Signs and symptoms</topic><topic>Thromboembolism</topic><topic>TNF inhibitors</topic><topic>Venous Thromboembolism - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Fleischmann, Roy</creatorcontrib><creatorcontrib>Pangan, Aileen L.</creatorcontrib><creatorcontrib>Song, In‐Ho</creatorcontrib><creatorcontrib>Mysler, Eduardo</creatorcontrib><creatorcontrib>Bessette, Louis</creatorcontrib><creatorcontrib>Peterfy, Charles</creatorcontrib><creatorcontrib>Durez, Patrick</creatorcontrib><creatorcontrib>Ostor, Andrew J.</creatorcontrib><creatorcontrib>Li, Yihan</creatorcontrib><creatorcontrib>Zhou, Yijie</creatorcontrib><creatorcontrib>Othman, Ahmed A.</creatorcontrib><creatorcontrib>Genovese, Mark C.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Immunology Abstracts</collection><collection>Nucleic Acids Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Arthritis & rheumatology (Hoboken, N.J.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fleischmann, Roy</au><au>Pangan, Aileen L.</au><au>Song, In‐Ho</au><au>Mysler, Eduardo</au><au>Bessette, Louis</au><au>Peterfy, Charles</au><au>Durez, Patrick</au><au>Ostor, Andrew J.</au><au>Li, Yihan</au><au>Zhou, Yijie</au><au>Othman, Ahmed A.</au><au>Genovese, Mark C.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Upadacitinib Versus Placebo or Adalimumab in Patients With Rheumatoid Arthritis and an Inadequate Response to Methotrexate: Results of a Phase III, Double‐Blind, Randomized Controlled Trial</atitle><jtitle>Arthritis & rheumatology (Hoboken, N.J.)</jtitle><addtitle>Arthritis Rheumatol</addtitle><date>2019-11</date><risdate>2019</risdate><volume>71</volume><issue>11</issue><spage>1788</spage><epage>1800</epage><pages>1788-1800</pages><issn>2326-5191</issn><eissn>2326-5205</eissn><abstract>Objective
To evaluate the efficacy, including capacity for inhibition of radiographic progression, and safety of upadacitinib, a JAK1‐selective inhibitor, as compared to placebo or adalimumab in patients with rheumatoid arthritis (RA) who have experienced an inadequate response to methotrexate (MTX).
Methods
In total, 1,629 RA patients with an inadequate response to MTX were randomized (2:2:1) to receive upadacitinib (15 mg once daily), placebo, or adalimumab (40 mg every other week) while continuing to take a stable background dose of MTX. The primary end points were achievement of an American College of Rheumatology 20% (ACR20) improvement response and a Disease Activity Score in 28 joints using C‐reactive protein level (DAS28‐CRP) of <2.6 in the upadacitinib group compared to the placebo group at week 12; inhibition of radiographic progression was evaluated at week 26. The study was also designed and powered to test for the noninferiority and superiority of upadacitinib compared to adalimumab, as measured both clinically and functionally.
Results
At week 12, both primary end points were met in patients receiving upadacitinib compared to those receiving placebo (P ≤ 0.001). An ACR20 improvement response was achieved by 71% of patients in the upadacitinib group compared to 36% in the placebo group, and a DAS28‐CRP score of <2.6 was observed in 29% of patients receiving upadacitinib compared to 6% of patients receiving placebo. Upadacitinib was superior to adalimumab based on the ACR50 response rate, achievement of a DAS28‐CRP score of ≤3.2, change in pain severity score, and change in the Health Assessment Questionnaire disability index. At week 26, more patients receiving upadacitinib than those receiving placebo or adalimumab achieved low disease activity or remission (P ≤ 0.001). Radiographic progression was significantly inhibited in patients receiving upadacitinib and was observed in fewer upadacitinib‐treated patients than placebo‐treated patients (P ≤ 0.001). Up to week 26, adverse events (AEs), including serious infections, were comparable between the upadacitinib and adalimumab groups. The proportions of patients with serious AEs and AEs leading to discontinuation were highest in the adalimumab group; the proportions of patients with herpes zoster and those with creatine phosphokinase (CPK) elevations were highest in the upadacitinib group. Three malignancies, 5 major adverse cardiovascular events, and 4 deaths were reported among the groups, but none occurred in patients receiving upadacitinib. Six venous thromboembolic events were reported (1 in the placebo group, 2 in the upadacitinib group, and 3 in the adalimumab group).
Conclusion
Upadacitinib was superior to placebo and adalimumab for improving signs, symptoms, and physical function in RA patients who were receiving background MTX. In addition, radiographic progression was significantly inhibited by upadacitinib as compared to placebo. The overall safety profile of upadacitinib was generally similar to that of adalimumab, except for higher rates of herpes zoster and CPK elevations in patients receiving upadacitinib.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>31287230</pmid><doi>10.1002/art.41032</doi><tpages>13</tpages><orcidid>https://orcid.org/0000-0002-4937-2775</orcidid><orcidid>https://orcid.org/0000-0002-6630-1477</orcidid><orcidid>https://orcid.org/0000-0001-5294-4503</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 2326-5191 |
| ispartof | Arthritis & rheumatology (Hoboken, N.J.), 2019-11, Vol.71 (11), p.1788-1800 |
| issn | 2326-5191 2326-5205 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2254517947 |
| source | MEDLINE; Wiley Online Library All Journals; Alma/SFX Local Collection |
| subjects | Adalimumab - therapeutic use Adult Aged Antirheumatic Agents - therapeutic use Arthritis Arthritis, Rheumatoid - diagnostic imaging Arthritis, Rheumatoid - drug therapy Arthritis, Rheumatoid - physiopathology Creatine Creatine kinase Creatine Kinase - metabolism Double-Blind Method Double-blind studies Drug Therapy, Combination Evaluation Female Health risk assessment Herpes zoster Herpes Zoster - epidemiology Heterocyclic Compounds, 3-Ring - therapeutic use Humans Immunotherapy Infections - epidemiology Janus kinase Janus Kinase Inhibitors - therapeutic use Joint diseases Male Methotrexate Methotrexate - therapeutic use Middle Aged Monoclonal antibodies Pain Randomization Remission Rheumatoid arthritis Safety Severity of Illness Index Signs and symptoms Thromboembolism TNF inhibitors Venous Thromboembolism - epidemiology |
| title | Upadacitinib Versus Placebo or Adalimumab in Patients With Rheumatoid Arthritis and an Inadequate Response to Methotrexate: Results of a Phase III, Double‐Blind, Randomized Controlled Trial |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-14T08%3A59%3A56IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Upadacitinib%20Versus%20Placebo%20or%20Adalimumab%20in%20Patients%20With%20Rheumatoid%20Arthritis%20and%20an%20Inadequate%20Response%20to%20Methotrexate:%20Results%20of%20a%20Phase%20III,%20Double%E2%80%90Blind,%20Randomized%20Controlled%20Trial&rft.jtitle=Arthritis%20&%20rheumatology%20(Hoboken,%20N.J.)&rft.au=Fleischmann,%20Roy&rft.date=2019-11&rft.volume=71&rft.issue=11&rft.spage=1788&rft.epage=1800&rft.pages=1788-1800&rft.issn=2326-5191&rft.eissn=2326-5205&rft_id=info:doi/10.1002/art.41032&rft_dat=%3Cproquest_cross%3E2254517947%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2309508765&rft_id=info:pmid/31287230&rfr_iscdi=true |