In individuals with moderate to severe rheumatoid arthritis who previously had insufficient responses to disease-modifying anti-rheumatic drugs (DMARDs) treatment, 15 mg Upadacitinib (UPA) once a day was efficacious in enhancing clinical and patient-reported outcomes when given either in combination with conventional synthetic DMARDs or as monotherapy, according to a post-hoc analysis of the SELECT Phase Ill trials. The effectiveness of UPA for moderately active rheumatoid arthritis was investigated by the researchers.

The 15 mg UPA once a day (monotherapy following switching from methotrexate or in conjunction with stable background conventional synthetic DMARDs) or placebo were given to participants. People with moderate disease activity (28-joint count Disease Activity Score using C-reactive protein  [DAS28(CRP)] of >3.2 and ≤5.1) and severe disease activity (DAS28(CRP) >5.1) had their clinical, functional, and radiological outcomes examined individually.

In comparison with placebo-recipients, people with moderate disease activity who were given 15 mg UPA (monotherapy or combination) were substantially more likely to meet the 20% American College of Rheumatology (ACR) response criteria, have low disease activity status (DAS28(CRP) ≤3.2), or be in clinical remission (DAS28(CRP) <2.6) by week 12/14. In comparison to the placebo, 15 mg UPA showed clinically meaningful enhancements in patient-reported functionality and pain at weeks 12 and 14.

By week 26, radiographic advancement was dramatically slowed down as compared to the placebo. Comparable advancements in severe illness were seen. Therefore, the use of UPA appears to be favorable for the management of moderate rheumatoid arthritis.