Short-term Clinical Outcomes of Upadacitinib in Patients with Rheumatoid Arthritis

Upadacitinib CAS No.: 1310726-60-3 was approved by the National Drug Administration (NMPA) on March 22, 2022 for the treatment of moderate-to-severe rheumatoid arthritis (RA).

From April 24 to 26, Fukuoka, Japan, hosted the 67th Annual Meeting of the Japanese Society of Rheumatology (JCR) 2023. Collaboration across diverse domains is taking place at this JCR meeting.

Research Purpose
To describe the clinical results of rheumatoid arthritis (RA) patients who received upatinib.

Research Methodology
The Japanese Niigata University Orthopaedic Surgery Rheumatoid Arthritis Database (NOSRAD) contains information from 20 RA patients—15 women and 5 men. Upadacitinib patients ranged in age from 47 to 85 years old, with a mean age of 68. The average number of years that patients had RA was 10 (4–30 years). 11 patients (about 55%) had RA that was refractory. A mean dose of 6.7 mg/week of methotrexate was administered to 6 patients. Prednisolone was administered to 6 patients at a dose of 3.4 mg/d. 11 individuals received Upadacitinib at a dose of 7.5 mg/d and 9 patients received a dose of 15 mg/d of ubatinib. In the trial, clinical outcomes and negative events were assessed.

Research Results
At the time of administration, the mean DAS28-ESR was 3.9; however, it dramatically fell to 2.2, 2.0, and 2.4 at 1, 3 and 6 months later (p 0.01). At the time of administration, the mean CDAI was 15, and at 1, 3, and 6 months after the dose, it considerably fell to 7.3, 5.0, and 5.9 (P 0.01). At 1 month following administration, the white blood cell count considerably dropped from 6588 at the time of administration to 6171 (P 0.05), but there was no discernible difference at 3 months. Although there was no significant difference after three months, the lymphocyte count increased considerably from 1425 at the time of administration to 1730 one month later (P 0.05). Herpes zoster, fever, and cough were found in one case each under adverse events. In the last 2 individuals, the daily upatinib dose was decreased from 15 mg to 7.5 mg. All three patients continued receiving upatinib therapy. The retention rate reached 100% by the end of the observation period (6 months).

Upadacitinib can reduce RA disease activity rapidly and has good efficacy even in patients with refractory RA. However, the observation period in this research was only 6 months, and no serious adverse events were found.

"There are many unmet needs in the treatment of rheumatoid arthritis, and fewer drugs remain a problem. For doctors or patients, we need more effective and safer medicines. The launch of Upatinib is a great blessing for RA patients." So said Professor Zeng Xiaofeng, Director of the Department of Rheumatology and Immunology at Beijing Union Medical College Hospital, during an exclusive interview with Medical Trends.