Efficacy of upadacitinib in subgroups of patients with axial spondyloarthritis with early versus established disease

Study Overview

This study looked at how effective a medication called upadacitinib is for patients with axial spondyloarthritis (axSpA), a type of arthritis that affects the spine. The goal was to see if starting treatment early makes a difference in long-term health outcomes.

Study Details

Researchers conducted two studies (SELECT-AXIS 1 and 2) involving patients who had either radiographic axSpA (r-axSpA) or non-radiographic axSpA (nr-axSpA). These patients had not previously received biologic treatments or had not responded well to them. Patients were divided based on how long they had symptoms: early (2 years or less) versus established (more than 2 years) and shorter (5 years or less) versus longer (more than 5 years).

Results

After 14 weeks of treatment, patients taking upadacitinib showed better results in managing their symptoms compared to those taking a placebo, regardless of how long they had been experiencing symptoms. However, there was a notable difference in one specific measure (high-sensitivity C-reactive protein) for patients with nr-axSpA, where those with early disease had a better response.

Conclusions

In the short term, both groups of patients (those with shorter and longer symptom durations) responded similarly to upadacitinib treatment. This suggests that starting treatment early may not significantly change immediate outcomes compared to starting later.