Evidence map›Paper›PMID 36018230›Full record

Trial reportRheumatology (Oxford, England)2023

Impact of initial therapy with upadacitinib or adalimumab on achievement of 48-week treatment goals in patients with rheumatoid arthritis: post hoc analysis of SELECT-COMPARE.

Eduardo Mysler, Yoshiya Tanaka, Arthur Kavanaugh, Daniel Aletaha, Peter C Taylor, In-Ho Song, Tim Shaw, Yanna Song, Ryan DeMasi, Mira Ali and 1 more

Registry-linked trialOpen access · greenAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Rheumatology (Oxford, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02629159 (A Phase 3, Randomized, Double-Blind Study Comparing Upadacitinib), which is not on this map. Cited by 7 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 3 pooled it
1.7field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02629159 phase3active not recruitingnot on this map

A Phase 3, Randomized, Double-Blind Study Comparing Upadacitinib (ABT-494) to Placebo and to Adalimumab in Subjects With Moderately to Severely Active Rheumatoid Arthritis Who Are on a Stable Background of Methotrexate (MTX) and Who Have an Inadequate Response to MTX (MTX-IR)

TypeinterventionalSponsorAbbVieRan2015 to 2027Enrolled1,629ConditionsRheumatoid ArthritisArmsPlacebo for Adalimumab, Adalimumab, Placebo for Upadacitinib, Upadacitinib
3 · Its place in the literature

Who cites it

7 citing papers in PubMed, 3 syntheses or guidelines pooled it, 11 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Review
  5. Towards an individualised approach to pain management in inflammatory arthritis.Therapeutic advances in musculoskeletal disease · 2026
    Review
  6. Article
  7. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 7 institutions in 4 countries.

Eduardo MyslerOrganización Medica de Investigación, Buenos Aires, Argentina.
Yoshiya TanakaThe First Department of Internal Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.ORCID 0000-0002-0807-7139
Arthur KavanaughDivision of Rheumatology, Allergy, & Immunology, University of California San Diego Medical School, San Diego, CA, USA.
Daniel AletahaDivision of Rheumatology, Department of Medicine, Medical University of Vienna, Vienna, Austria.
Peter C TaylorBotnar Research Centre, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.ORCID 0000-0001-7766-6167
In-Ho SongAbbVie, North Chicago, IL, USA.
Tim ShawAbbVie Ltd, Maidenhead, UK.
Yanna SongAbbVie, North Chicago, IL, USA.
Ryan DeMasiAbbVie, North Chicago, IL, USA.
Mira AliAbbVie, North Chicago, IL, USA.
Roy FleischmannDepartment of Medicine, University of Texas Southwestern Medical Center, Metroplex Clinical Research Center, Dallas, TX, USA.
AbbVie (United States) · USAbbVie (United Kingdom) · GBMedical University of Vienna · ATMetroplex Clinical Research Center · USNuffield Orthopaedic Centre · GBUniversity of California San Diego · USUniversity of Occupational and Environmental Health Japan · JP

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesEvaluate the importance of treatment sequencing in SELECT-COMPARE, assessing potential differences between starting upadacitinib or adalimumab therapy following inadequate MTX response.

methodsPatients from SELECT-COMPARE were randomized to upadacitinib 15 mg once daily, placebo or adalimumab 40 mg. Per protocol, patients with <20% improvement in tender or swollen joint counts (weeks 14, 18, 22) or failure to achieve Clinical Disease Activity Index (CDAI) low disease activity (LDA) at week 26 were blindly switched from upadacitinib to adalimumab or vice versa. Treatment outcomes, including clinical remission/LDA, physical function, pain and a novel combined endpoint for deep response, were evaluated through 48 weeks and corresponding time-averaged response rates determined. Data were analysed by initial randomized group regardless of any subsequent switch in therapy.

resultsThis post hoc analysis included 651 patients initially randomized to upadacitinib (of whom 252 switched to adalimumab) and 327 patients initially randomized to adalimumab (of whom 159 switched to upadacitinib). At week 48, patients randomized to either therapy demonstrated similar achievement of most treatment endpoints. Greater improvements in the total time spent in a lower disease state were observed for initial upadacitinib vs initial adalimumab therapy across most clinical and patient-reported outcomes through 48 weeks, and the median time to DAS28(CRP) <2.6/≤3.2 occurred 6-8 weeks earlier among those randomized to upadacitinib.

conclusionFollowing a modified treat-to-target strategy, rates of CDAI remission/LDA and DAS28(CRP) <2.6/≤3.2 at 48 weeks were similar, regardless of starting therapy. However, patients initially receiving upadacitinib reached treatment targets more quickly and spent more time in clinical targets over the initial 48 weeks of treatment.

trial registrationClinicalTrials.gov, https://clinicaltrials.gov, NCT02629159.

Indexed as

Antirheumatic AgentsArthritis, RheumatoidAdalimumabDouble-Blind MethodDrug Therapy, CombinationGoalsHeterocyclic Compounds, 3-RingHumansMethotrexateTreatment OutcomeAdalimumabAntirheumatic AgentsHeterocyclic Compounds, 3-RingMethotrexateupadacitinibbDMARDclinical trialsJAK inhibitorsRAtreatment strategytreat-to-target

Identifiers

PMID36018230
PMCPMC10152292
OpenAlexW4293116145

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.