Upadacitinib Benefits Quality of Life and Work Productivity in Adults With NrAxSpA

Upadacitinib led to rapid and clinically meaningful gains in health-related quality of life (HRQoL) and work productivity compared with placebo in patients with active nonradiographic axial spondyloarthritis (nr-axSpA), according to study results published in Rheumatology and Therapy.

“Furthermore, clinically important improvements in HRQoL were consistently observed regardless of prior treatment with tumor necrosis factor inhibitors, thus providing further evidence substantiating the overarching benefit of upadacitinib in patients with active nr-axSpA,” wrote corresponding author Uta Kiltz, MD, of Ruhr University Bochum in Germany, and study coauthors.

The analysis investigated the effect of upadacitinib 15 mg once daily compared with placebo in adults with nr-axSpA from in the SELECT-AXIS 2 phase 3 randomized controlled trial. Specifically, researchers were interested in mean changes between baseline and 14 weeks in patient-reported outcomes gauging HRQoL (Ankylosing Spondylitis QoL [ASQoL], Assessment of SpondyloArthritis international Society Health Index [ASAS HI], and Short-Form 36 Physical Component Summary [SF-36 PCS] measures) and work productivity (Work Productivity and Activity Impairment [WPAI] questionnaire domains).

All of the HRQoL measures, and 3 of 4 WPAI domains (presenteeism, overall work impairment, and activity impairment), improved more with upadacitinib compared with placebo, according to the study. Improvement in in the WPAI absenteeism domain was similar between treatments.

With upadacitinib, 62.6% of patients achieved clinically meaningful improvements on ASQoL (compared with 40.9% with placebo), 44.8% achieved clinically meaningful improvements on ASAS HI (compared with 28.8% on placebo), and 69.3% achieved clinically meaningful improvements on SF-36 PCS (compared with 52% on placebo) by week 14, the study found. HRQoL improvements were seen as early as week 2 on the ASAS HI and week 4 on the ASQoL and SF-36 PCS.

“These findings, together with previously reported efficacy and safety in patients with active ankylosing spondylitis, provide further evidence for the benefit of upadacitinib across all active axSpA patients,” researchers wrote.

Reference

Kiltz U, Kishimoto M, Walsh JA, et al. Effect of upadacitinib on quality of life and work productivity in active non-radiographic axial spondyloarthritis: results from randomized phase 3 trial SELECT-AXIS 2. Rheumatol Ther. 2023;10(4):887-899. doi:10.1007/s40744-023-00550-4