Retention rate of upadacitinib therapy in rheumatoid arthritis: Results of a large italian multicenter real-world study
Vol. 32 No. 1 (2024), Original Articles
Vol. 32 No. 1 (2024)

Retention rate of upadacitinib therapy in rheumatoid arthritis: Results of a large italian multicenter real-world study

Original Articles
https://doi.org/10.35465/32.1.2024.pp22-29
Published June 13, 2024
Palma Scolieri
Rheumatology Unit, Nuovo Regina Margherita Hospital, 00154 Roma, Italy
Andrea Becciolini
2. Internal Medicine and Rheumatology Unit, University Hospital of Parma, 43126 Parma, Italy
https://orcid.org/0000-0002-1051-8511
Alarico Ariani
2. Internal Medicine and Rheumatology Unit, University Hospital of Parma, 43126 Parma, Italy
https://orcid.org/0000-0003-1428-6102
Elena Bravi
Rheumatology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy
Marino Paroli
Department of Clinical, Internist, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, 00185 Rome, Italy
https://orcid.org/0000-0001-7919-9128
Romina Andracco
Internal Medicine Unit, Imperia Hospital, 18100 Imperia, Italy
Valeria Nucera
Rheumatology Unit, ASL Novara, 28100 Novara, Italy
Simone Parisi
6. Rheumatology Department, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di To-rino, 10126 Torino, Italy
https://orcid.org/0000-0003-4496-8315
Francesca Ometto
Rheumatology Unit, Azienda ULSS 6 Euganea, 35131 Padova, Italy
Federica Lumetti
8. Rheumatology Unit, Azienda USL of Modena and AOU Policlinico of Modena, 41100 Modena, Italy
Antonella Farina
Internal Medicine Unit, Augusto Murri Hospital, 63900 Fermo, Italy
https://orcid.org/0000-0003-2086-727X
Patrizia Del Medico
Internal Medicine Unit, Civitanova Marche Hospital, 62012 Civitanova Marche, Italy
Matteo Colina
Rheumatology Unit, Internal Medicine Division, Department of Medicine and Oncology, Santa Maria della Scaletta Hospital, Imola, Italy and Rheumatology Unit, Alma Mater Studiorum—University of Bologna, 40126 Bologna, Italy
https://orcid.org/0000-0002-1174-2849
Viviana Ravagnani
Rheumatology Unit, Santa Chiara Hospital APSS—Trento, 38122 Trento, Italy
Maddalena Larosa
Marta Priora
Elisa Visalli
Olga Addimanda
Rosetta Vitetta
Alessandro Volpe
Alessandra Bezzi
Francesco Girelli
Aldo Biagio Molica Colella
Rosalba Caccavale
Eleonora Di Donato
Giuditta Adorni
Daniele Santilli
Gianluca Lucchini
Eugenio Arrigoni
Ilaria Platè
Natalia Mansueto
Aurora Ianniello
Enrico Fusaro
Maria Chiara Ditto
Vincenzo Bruzzese
Dario Camellino
Gerolamo Bianchi
Francesca Serale
Rosario Foti
Giorgio Amato
Francesco De Lucia
Ylenia Dal Bosco
Roberta Foti
Massimo Reta
Alessia Fiorenza
Guido Rovera
Antonio Marchetta
Maria Cristina Focherini
Fabio Mascella
Simone Bernardi
Gilda Sandri
Dilia Giuggioli
Carlo Salvarani
Veronica Franchina
Francesco Molica Colella
Giulio Ferrero
Alberto Lo Gullo
arnas garibaldi, Catania
https://orcid.org/0000-0003-4383-0314
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Keywords

Retention rate; upadacitinib, rheumatoid arthritis, JAK inhibitors

How to Cite

Scolieri, P., Becciolini, A., Ariani, A., Bravi, E., Paroli, M., Andracco, R., Nucera, V., Parisi, S., Ometto, F., Lumetti, F., Farina, A., Del Medico, P., Colina, M., Ravagnani, V., Larosa, M., Priora, M., Visalli, E., Addimanda, O., Vitetta, R., Volpe, A., Bezzi, A., Girelli, F., Molica Colella, A. B., Caccavale, R., Di Donato, E., Adorni, G., Santilli, D., Lucchini, G., Arrigoni, E., Platè, I., Mansueto, N., Ianniello, A., Fusaro, E., Ditto, M. C., Bruzzese, V., Camellino, D., Bianchi, G., Serale, F., Foti, R., Amato, G., De Lucia, F., Dal Bosco, Y., Foti, R., Reta, M., Fiorenza, A., Rovera, G., Marchetta, A., Focherini, M. C., Mascella, F., Bernardi, S., Sandri, G., Giuggioli, D., Salvarani, C., Franchina, V., Molica Colella, F., Ferrero, G., & Lo Gullo, A. (2024). Retention rate of upadacitinib therapy in rheumatoid arthritis: Results of a large italian multicenter real-world study. Rheumatology (Bulgaria), 32(1), 22-29. https://doi.org/10.35465/32.1.2024.pp22-29
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Abstract

Introduction: Upadacitinib (UPA) is an oral Janus kinase inhibitor (JAKi) recently approved for the treatment rheumatoid arthritis (RA) treatment. Although registrational studies have demonstrated the efficacy of UPA in RA, data on the long-term retention rate of this drug are still lacking. Objective: The objective of his study was to evaluate the real-world retention rate of UPA in patients with RA, analyze possible reasons for treatment discontinuation, and attempt to identify independent factors possibly associated with persistence of UPA treatment Methods: We conducted a multicenter retrospective observational study of patients with RA referred to tertiary rheumatology hospitals in Italy. One-hundred-eleven consecutive patients who received UPA in different lines of treatment were enrolled. Clinical history, previous treatments, and RA disease activity at baseline were recorded. The retention rate of UPA was assessed by Kaplan-Meier curve study. Cox proportional regression analysis was also performed to study the effect of independent factors on UPA therapy retention rate including age, sex, smoking habit, presence of anti-citrullinated protein antibody (ACPA)/rheumatoid factor (RF), disease duration, disease activity, line of treatment and concomitant treatments. Results: Analysis of demographic data revealed an M:F ration of 28:83, a median age of 58  years with an interquartile Range (IQR) of 50-65 years,  and  a median disease duration 78 months (IQR: 40-167) . The median observation period was 6.0 months (IQR 3.2-10.0). Most patients were on monotherapy or receiving concomitant steroids (55.0% and 58.6%, respectively). The UPA retention rate at 6 and 12 months was 90.4% and 74.7%, respectively. Reasons for treatment discontinuation included lack of efficacy (8/19), lost of efficacy (6/19) infections (3/19) and cancer onset (2/19). Other factors affecting the rate of UPA maintenance were duration of illness and RA seropositivity. Conclusion: The high retention rate of UPA indirectly suggests the good efficacy and acceptable safety profile of this drug in RA therapy. From our study data, we conclude that UPA could be an appropriate choice in most patients with RA, even after failure of previous lines of treatment. We also found that the drug had a higher retention rate in patients with seropositive RA than in their seronegative counterparts.

https://doi.org/10.35465/32.1.2024.pp22-29
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