gms | German Medical Science

Introduction: Background: Psoriatic arthritis (PsA) is a systemic, chronic inflammatory disease with multiple clinically relevant symptoms [1], [2], [3]. Joint involvement may be oligo- or polyarticular (oPsA/pPsA), and comparisons of these entities are rare. UPJOINT, the first real-world, post-marketing observational study in PsA patients treated with Upadacitinib, aims to add evidence to this gap.

Methods: The prospective, open-label, multicenter, non-interventional, post-marketing UPJOINT study included adult PsA patients with at least one swollen joint count [SJC 66 ≥ 1]. Subjects were treated with 15 mg UPA once daily and assigned to oPsA (SJC ≤ 4) – or pPsA at baseline. Analyzed measures included: proportion of patients with minimal disease activity (MDA), Disease Activity in PSoriatic Arthritis (DAPSA) score, C-reactive protein (CRP), number of tender and swollen joints (TJC68 & SJC66), Body Surface Area (BSA), Leeds Enthesitis Index (LEI), presence of dactylitis and nail psoriasis. Patient’s reported outcomes were assessed for global disease activity and pain, the Health Assessment Questionnaire – Disability Index (HAQ-DI), the Bath Ankylosing Disease Activity Index (BASDAI), the Short Form-12 (SF-12) and the Dermatology Life Quality Index (DLQI). For this analysis, missing values were not imputed.

Results: 213 patients (oPsA: 95 [44.6%]; pPsA: 118 [55.4%]) were included, whereas mean age and disease duration were 53.7 and 8.9 years, respectively. In both subgroups, the proportion of patients previously treated with biological or targeted-synthetic disease-modifying antirheumatic drugs (bDMARDs/tsDMARDs) was similar, whereas 17.9% patients with oPsA and 23.7% with pPsA had received ≥ 3 previous bDMARDs/tsDMARDs (Figure 1 [Fig. 1]). Apart from the joint-determined clinical disease activity measures, which indicated higher activity in pPsA, results for measures of psoriasis, enthesitis, dactylitis, BASDAI and SF-12 were similar for oPsA and pPsA (Table 1 [Tab. 1]). Overall, the BSA percentage of 3.1, reflects moderate psoriasis, whereas mean DLQI score of 7.1 seemed moderately impaired by psoriasis.

Conclusion: Aside from joint-determined disease activity measures, baseline characteristics in oPsA and pPsA appear similar regarding enthesitis, psoriasis or dactylitis, and quality of life. Interestingly, roughly a fifth of this real-world PsA patient sample was previously treated with ≥ 3 bDMARDs/tsDMARDs before UPA initiation.

Disclosures: AH has received consultancy or speaker honorary from Abbvie, BMS, Eli Lilly, Galapagos, Gilead, Novartis, UCB and received funding for investigator-initiated studies from Novartis. SW has received consulting fees and/or honoraria from Abbvie, Janssen-Cilag, Pfizer. PS has received consulting fees and/or honoraria from Abbvie. MF has received consulting fees and/or honoraria from AMGEN, Janssen-Cilag, Novartis,UCB and Pfizer. JW has received consulting fees and/or honoraria from Pfizer, Fraunhofer Institut, Gilead, GSK, Janssen-Cilag, Medac and Novartis. KJ, AR and CH are employees of AbbVie and may own AbbVie stock. AbbVie sponsored the study; contributed to the design; participated in the collection, analysis, and interpretation of data; in writing, reviewing, and approval of the final version. No honoraria or payments were made for authorship.

Acknowledgements: Statistical analysis support was provided by Maria Kabelitz and Dr. Daniela Adolf of StatConsult Gesellschaft für klinische und Versorgungsforschung mbH, which was funded by AbbVie. Medical Writing support was provided by Dr. Matthias Englbrecht and was funded by AbbVie.