JAK Inhibitor Improves Slate of Patient-Reported Outcomes in Biologic Refractory Ankylosing Spondylitis

Patients with ankylosing spondylitis with inadequate responses or intolerance to biologic disease-modifying antirheumatic drugs (bDMARD-IR) demonstrated clinically meaningful improvements in disease activity, pain, fatigue, function, health-related quality of life (HRQoL), and work productivity at week 14 with upadacitinib compared to placebo. Researchers published their findings in Rheumatology and Therapy.

“Rapid improvements from baseline were seen as early as week 1 for disease-specific and general HRQoL patient-reported measures,” wrote corresponding author Victoria Navarro-Compán, MD, PhD, of the La Paz University Hospital Department of Rheumatology, Madrid, Spain, and coauthors.

This study reported the impact of upadacitinib on clinically meaningful improvement in patient-reported outcomes over 14 weeks from the phase 3 SELECT-AXIS 2 trial. The study included 420 patients with active ankylosing spondylitis who were bDMARD-IR. Participants were randomized 1:1 to receive upadacitinib 15 mg once daily or placebo.

Across all patient-reported outcomes, a higher proportion of patients reported minimum clinically important differences at week 14 with upadacitinib compared to placebo, according to the study. 

At week 14, improvements were greater with upadacitinib across the Functional Assessment of Chronic Illness Therapy-Fatigue, Assessment of SpondyloArthritis international Society Health Index, and Work Productivity and Activity Impairment Questionnaire. Better gains with upadacitinib were evident as early as week 1 on the Assessment of SpondyloArthritis international Society Health Index, Ankylosing Spondylitis Quality of Life scale, and the Short Form-36 physical component summary, and by week 4 on the Short Form-36 mental component summary.

“These findings are in line with the SELECT-AXIS 1 study, which previously demonstrated significant improvement in a bDMARD-naïve ankylosing spondylitis population…” researchers wrote. “The current study in bDMARD-IR patients provides further evidence supporting upadacitinib as a promising treatment option for this treatment-refractory population, particularly given the large number of patients with ankylosing spondylitis who do not achieve desired treatment goals on current biologic therapies.”

Reference:
Navarro-Compán V, Baraliakos X, Magrey M, et al. Effect of upadacitinib on disease activity, pain, fatigue, function, health-related quality of life and work productivity for biologic refractory ankylosing spondylitis. Rheumatol Ther. Published online February 23, 2023. doi:10.1007/s40744-023-00536-2