Evidence map›Paper›PMID 39757285›Full record

ArticleRheumatology and therapy2025

Real-World Persistence and Effectiveness of Upadacitinib versus Other Janus Kinase Inhibitors and Tumor Necrosis Factor Inhibitors in Australian Patients with Rheumatoid Arthritis.

Peter Youssef, Sabina Ciciriello, Talib Tahir, Joanna Leadbetter, Belinda Butcher, Miriam Calao, Nicole Walsh, Catherine O'Sullivan, Tegan Smith, Geoffrey Littlejohn

Erratum issuedAbstract read
In one paragraph

Article in Rheumatology and therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 9 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
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  5. Observational
  6. Article
  7. Article
  8. Review
  9. Observational
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors.

Peter YoussefInstitute for Musculoskeletal Health at University of Sydney, Sydney, NSW, Australia.
Sabina CicirielloOPAL Rheumatology Ltd, Sydney, NSW, Australia.
Talib TahirCoburg Rheumatology Service, Coburg, VIC, Australia.
Joanna LeadbetterWriteSource Medical Pty Ltd, Lane Cove, NSW, Australia.
Belinda ButcherWriteSource Medical Pty Ltd, Lane Cove, NSW, Australia.
Miriam CalaoAbbVie Pty Ltd., Mascot, NSW, Australia.
Nicole WalshAbbVie Pty Ltd., Mascot, NSW, Australia.
Catherine O'SullivanOPAL Rheumatology Ltd, Sydney, NSW, Australia.
Tegan SmithOPAL Rheumatology Ltd, Sydney, NSW, Australia.
Geoffrey LittlejohnOPAL Rheumatology Ltd, Sydney, NSW, Australia. geoff.littlejohn@monash.edu.ORCID http://orcid.org/0000-0002-7896-055X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionThis study sought to describe treatment patterns, persistence, and effectiveness of upadacitinib (UPA) alone and compared to other Janus kinase inhibitors (JAKis) or tumor necrosis factor inhibitors (TNFis) in patients with rheumatoid arthritis (RA).

methodsThis retrospective, non-interventional study used the OPAL dataset, derived from electronic medical records. Patients initiated UPA (N = 2624), other JAKis (baricitinib and tofacitinib [N = 925]), or TNFis (adalimumab, etanercept, certolizumab, golimumab, infliximab [N = 3540]) between May 2020 and March 2023. Median persistence (Kaplan-Meier) and effectiveness (Disease Activity Score 28-joint C-reactive protein, three variables [DAS28CRP{3}]) were evaluated for UPA-treated patients and in three propensity score-matched cohorts: UPA monotherapy versus combination therapy, UPA versus other JAKis, and UPA versus TNFis.

resultsIn patients prescribed UPA, 41.3% were ≥ 65 years old, 33.8% were prescribed as first-line advanced therapy, and 27.2% were prescribed monotherapy. Persistence on UPA was 26.6 months (95% confidence intervals: 24.4, 29.9) and longest in earlier lines of therapy. The DAS28CRP(3) remission rate was 73% at 3 months, with improvements observed across lines of therapy. UPA monotherapy and combination therapy had similar persistence (27.8 [23.5, 33.4] versus 30.4 months [22.1, 35.3], p = 0.84) and effectiveness. UPA showed longer persistence than other JAKis (28.8 [25.6, 32.4] versus 17.2 months [14.9, 19.8], p < 0.001) and TNFis (26.6 [24.9, 30.8] versus 13.3 months [11.5, 14.5], p < 0.001). DAS28CRP(3) remission rates were greater at 3 months for UPA than other JAKis (75.0% versus 61.5%) and TNFis (72.7% versus 59.5%). In unmatched subgroups, compared to cycling between TNFis, switching to UPA from other JAKis or TNFis resulted in longer persistence (JAKi-to-UPA: 25.3 [16.1, not reached]; TNFi-to-UPA: 27.8 [23.2, 35.4]; TNFi-to-TNFi: 9.6 [8.4, 10.7]) and greater DAS28CRP(3) remission rates over 9 months.

conclusionsOverall, the breadth and depth of data from this large real-world dataset continue to support a favorable clinical profile of UPA for the treatment of RA and may inform treatment choices in everyday clinical practice.

Indexed as

AustraliaBiologic disease-modifying antirheumatic drug (bDMARD)Janus kinase inhibitor (JAKi)PersistenceReal-world effectivenessRemissionRheumatoid arthritis (RA)Targeted synthetic disease-modifying antirheumatic drug (tsDMARD)Tumor necrosis factor inhibitor (TNFi)Upadacitinib (UPA)

Identifiers

PMID39757285
PMCPMC11751354

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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.