Evidence map›Paper›PMID 37982966›Full record

ArticleRheumatology and therapy2024

Malignancy in the Upadacitinib Clinical Trials for Rheumatoid Arthritis, Psoriatic Arthritis, Ankylosing Spondylitis, and Non-radiographic Axial Spondyloarthritis.

Andrea Rubbert-Roth, Adriana M Kakehasi, Tsutomu Takeuchi, Marc Schmalzing, Hannah Palac, Derek Coombs, Jianzhong Liu, Samuel I Anyanwu, Ralph Lippe, Jeffrey R Curtis

10 registry-linked trialsOpen access · goldAbstract read
In one paragraph

Article in Rheumatology and therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 10 registered trials, which are not on this map. Cited by 13 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
13citing papers in PubMed, 1 pooled it
5.2field-weighted citation impact, top 4% 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
NCT02675426 phase3completednot on this map

A Phase 3, Randomized, Double-Blind Study Comparing Upadacitinib (ABT-494) to Placebo in Subjects With Moderately to Severely Active Rheumatoid Arthritis Who Are on a Stable Dose of Conventional Synthetic Disease-Modifying Anti-Rheumatic Drugs (csDMARDs) and Have an Inadequate Response to csDMARDs

TypeinterventionalSponsorAbbVieRan2015 to 2022Enrolled661ConditionsRheumatoid ArthritisArmsPlacebo, Upadacitinib
NCT02706847 phase3completednot on this map

A Phase 3, Randomized, Double-Blind Study Comparing Upadacitinib (ABT-494) to Placebo on Stable Conventional Synthetic Disease-Modifying Anti-Rheumatic Drugs (csDMARDs) in Subjects With Moderately to Severely Active Rheumatoid Arthritis With Inadequate Response or Intolerance to Biologic DMARDs (bDMARDs)

TypeinterventionalSponsorAbbVieRan2016 to 2022Enrolled499ConditionsRheumatoid ArthritisArmsPlacebo, Upadacitinib
NCT02706873 phase3completednot on this map

A Phase 3, Randomized, Double-Blind Study Comparing Upadacitinib (ABT-494) Once Daily Monotherapy to Methotrexate (MTX) Monotherapy in MTX-Naïve Subjects With Moderately to Severely Active Rheumatoid Arthritis

TypeinterventionalSponsorAbbVieRan2016 to 2022Enrolled1,002ConditionsRheumatoid ArthritisArmsPlacebo to Upadacitinib, Methotrexate, Placebo to Methotrexate, Upadacitinib
NCT02706951 phase3completednot on this map

A Phase 3, Randomized, Double-Blind Study Comparing Upadacitinib (ABT-494) Monotherapy to Methotrexate (MTX) in Adults With Moderately to Severely Active Rheumatoid Arthritis With Inadequate Response to MTX

TypeinterventionalSponsorAbbVieRan2016 to 2022Enrolled648ConditionsRheumatoid ArthritisArmsMethotrexate, Upadacitinib, Placebo Upadacitinib, Placebo Methotrexate
NCT03086343 phase3completednot on this map

A Phase 3, Randomized, Active-Controlled, Double-Blind Study Comparing Upadacitinib (ABT-494) to Abatacept in Subjects With Moderately to Severely Active Rheumatoid Arthritis With Inadequate Response or Intolerance to Biologic DMARDs (bDMARDs) on Stable Conventional Synthetic Disease Modifying Anti-Rheumatic Drugs (csDMARDs)

TypeinterventionalSponsorAbbVieRan2017 to 2023Enrolled657ConditionsRheumatoid Arthritis (RA)ArmsAbatacept, Placebo for abatacept (0.9% Sodium Chloride Injection or Solution for Infusion), Upadacitinib, Placebo for upadacitinib
NCT03104374 phase3completednot on this map

A Phase 3, Randomized, Double-Blind, Study Comparing Upadacitinib (ABT-494) to Placebo in Subjects With Active Psoriatic Arthritis Who Have a History of Inadequate Response to at Least One Biologic Disease Modifying Anti-Rheumatic Drug (bDMARD)

TypeinterventionalSponsorAbbVieRan2017 to 2024Enrolled642ConditionsPsoriatic ArthritisArmsPlacebo, Upadacitinib
NCT03104400 phase3completednot on this map

A Phase 3, Randomized, Double-Blind, Study Comparing Upadacitinib (ABT-494) to Placebo and to Adalimumab in Subjects With Active Psoriatic Arthritis Who Have a History of Inadequate Response to at Least One Non-Biologic Disease Modifying Anti-Rheumatic Drug (DMARD) - SELECT - PsA 1

TypeinterventionalSponsorAbbVieRan2017 to 2024Enrolled1,705ConditionsPsoriatic ArthritisArmsAdalimumab, Upadacitinib, Placebo to Upadacitinib, Placebo to Adalimumab
NCT03178487 phase2completednot on this map

A Multicenter, Randomized, Double-Blind, Placebo-Controlled Study Evaluating the Safety and Efficacy of Upadacitinib in Subjects With Active Ankylosing Spondylitis

TypeinterventionalSponsorAbbVieRan2017 to 2022Enrolled187ConditionsAnkylosing Spondylitis (AS)ArmsUpadacitinib, Placebo
NCT04169373 phase3completednot on this map

A Phase 3 Randomized, Placebo-Controlled, Double-Blind Program to Evaluate Efficacy and Safety of Upadacitinib in Adult Subjects With Axial Spondyloarthritis Followed by a Remission-Withdrawal Period

TypeinterventionalSponsorAbbVieRan2019 to 2025Enrolled734ConditionsSpondyloarthritisArmsUpadacitinib, Placebo
3 · Its place in the literature

Who cites it

13 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 5 countries.

Andrea Rubbert-RothDivision of Rheumatology, Cantonal Clinic St Gallen, Rorschacherstrasse 95, St Gallen, Switzerland. andrea.rubbert-roth@kssg.ch.ORCID http://orcid.org/0000-0002-9016-2833
Adriana M KakehasiHospital das Clínicas, Federal University of Minas Gerais, Belo Horizonte, Brazil.
Tsutomu TakeuchiKeio University School of Medicine, Tokyo, Japan.
Marc SchmalzingRheumatology/Clinical Immunology, Department of Internal Medicine II, University of Wϋrzburg, Würzburg, Germany.
Hannah PalacAbbVie Inc., North Chicago, IL, USA.
Derek CoombsAbbVie Inc., North Chicago, IL, USA.
Jianzhong LiuAbbVie Inc., North Chicago, IL, USA.
Samuel I AnyanwuAbbVie Inc., North Chicago, IL, USA.
Ralph LippeAbbVie Deutschland GmbH & Co. KG, Wiesbaden, Germany.
Jeffrey R CurtisDivision of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, Birmingham, AL, USA.
AbbVie (United States) · USAbbVie (Germany) · DEKeio University · JPUniversidade Federal de Minas Gerais · BRUniversity of Alabama at Birmingham · USUniversity of St.Gallen · CHUniversity of Würzburg · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis article aims to describe malignancies in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), or non-radiographic axial spondyloarthritis (nr-axSpA) treated with upadacitinib (UPA) or active comparators.

methodsThis integrated safety analysis includes data from 11 phase 3 UPA trials across RA (6 trials), PsA (2 trials), AS (2 trials; one phase 2b/3), and nr-axSpA (1 trial). Treatment-emergent adverse events (TEAEs) were summarized for RA (pooled UPA 15 mg [UPA15], pooled UPA 30 mg [UPA30], adalimumab 40 mg [ADA], methotrexate monotherapy [MTX]), PsA (pooled UPA15, pooled UPA30, ADA), AS (pooled UPA15), and nr-axSpA (UPA15). TEAEs were reported as exposure-adjusted event rates (events/100 patient-years).

resultsMedian treatment duration ranged from 1.0 to 4.0 years (with a maximum of 6.6 years in RA). Across treatments and indications, rates of malignancy excluding nonmelanoma skin cancer (NMSC) ranged from 0.2 to 1.1, while NMSC ranged from 0.0 to 1.4. In RA, rates of malignancy excluding NMSC were generally similar between UPA15, UPA30, ADA, and MTX (breast and lung cancer were the most common). In RA and PsA, Kaplan-Meier analyses revealed no differences in event onset of malignancy excluding NMSC with UPA15 versus UPA30 over time. In RA, NMSC rates were higher with UPA30 than UPA15; both UPA15 and UPA30 were higher than ADA and MTX. In PsA, rates of malignancy excluding NMSC and NMSC were generally similar between UPA15, UPA30, and ADA. In AS and nr-axSpA, malignancies were reported infrequently. Few events of lymphoma were reported across the clinical programs.

conclusionRates of malignancy excluding NMSC were generally similar between UPA15, UPA30, ADA, and MTX and were consistent across RA, PsA, AS, and nr-axSpA. A dose-dependent increased rate of NMSC was observed with UPA in RA.

trial registrationClinicaTrials.gov identifier: NCT02706873, NCT02675426, NCT02629159, NCT02706951, NCT02706847, NCT03086343, NCT03104400, NCT03104374, NCT03178487, and NCT04169373.

Indexed as

Ankylosing spondylitis (AS)Janus kinase (JAK) inhibitorMalignancyNonmelanoma skin cancer (NMSC)Non-radiographic axial spondyloarthritis (nr-axSpA)Psoriatic arthritis (PsA)Rheumatoid arthritis (RA)Risk factorsSpondyloarthritis (SpA)Upadacitinib (UPA)

Identifiers

PMID37982966
PMCPMC10796874
OpenAlexW4388828518

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

and 4 more above

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.