Treatment with Upadacitinib in Difficult-to-Treat (D2T) Psoriatic Arthritis (PsA): A National Multicenter Study of the First 134 Patients in Clinical Practice

• DOI: 10.3390/sci7020067
• Publication Date: 2025-05-14T16:22:17Z
• Authors: Eva Galíndez-Agir...; Diana Prieto-Peña; Maria Luz García-...; Joaquin Maria Bel...; Beatriz Joven-Ibáñez; Cristina Vergara-...; Marina Pavía-Pascual; Irati Urionaguena...; Lucia Vega Alvarez; M. Ángeles Puche ...; Consuelo Ramos Gi...; Rosario Garcia-Vi...; Vega Jovani; Angels Martínez-F...; Mireia Moreno Mar...; Teresa González H...; Raquel Almodóvar ...; Ana Urruticoechea...; Cristina Macía-Villa; Inigo Gorostiza; Ricardo Blanco Al...
• Keywords: Clinical Practice

Upadacitinib has demonstrated efficacy in psoriatic arthritis clinical trials, but its real-world performance difficult-to-treat PsA remains underexplored. This observational, multicenter, open-label study evaluated the and safety of upadacitinib 134 patients with (97 women, mean age 51.8 ± 11.2 years, disease duration 9.94 7.72 years) who showed inadequate response to advanced therapies. Most (74.6%) had received at least two biological/targeted synthetic disease-modifying antirheumatic drugs different mechanisms action. was initiated 15 mg daily, within one month, significant improvements were observed: DAS28-ESR decreased from 4.7 3.77 (p < 0.001), DAPSA 25 17 CRP 2.90 1.50 mg/L = 0.001). These reductions persisted throughout study. Prednisone dosage significantly 0.049). Adverse events led discontinuation 8.2% patients, no serious adverse reported. Compared SELECT-PsA 2 trial, our cohort a higher proportion females greater prior exposure biologic agents comparable outcomes. findings suggest that is rapid, effective, relatively safe therapeutic option for under conditions, supporting use despite differing patient characteristics trial populations.