Impact of Upadacitinib on Laboratory Parameters and Related Adverse Events in Patients with RA: Integrated Data Up to 6.5 Years
Abstract Introduction Upadacitinib (UPA) is a Janus kinase inhibitor that has demonstrated efficacy in moderate-to-severe rheumatoid arthritis (RA) with an acceptable safety profile. We investigated laboratory parameter changes in UPA RA clinical trials. Methods Pooled data from six randomized trial...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Adis, Springer Healthcare
2024-01-01
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| Series: | Rheumatology and Therapy |
| Subjects: | |
| Online Access: | https://doi.org/10.1007/s40744-023-00624-3 |
| _version_ | 1827377130520969216 |
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| author | Christina Charles-Schoeman Jon T. Giles Nancy E. Lane Ernest Choy Daniel E. Furst Jiří Vencovský Anthony G. Wilson Gerd R. Burmester Derek Coombs Sara K. Penn Nasser Khan Jillian B. Yee Kassim Rahawi Iain B. McInnes |
| author_facet | Christina Charles-Schoeman Jon T. Giles Nancy E. Lane Ernest Choy Daniel E. Furst Jiří Vencovský Anthony G. Wilson Gerd R. Burmester Derek Coombs Sara K. Penn Nasser Khan Jillian B. Yee Kassim Rahawi Iain B. McInnes |
| author_sort | Christina Charles-Schoeman |
| collection | DOAJ |
| description | Abstract Introduction Upadacitinib (UPA) is a Janus kinase inhibitor that has demonstrated efficacy in moderate-to-severe rheumatoid arthritis (RA) with an acceptable safety profile. We investigated laboratory parameter changes in UPA RA clinical trials. Methods Pooled data from six randomized trials in the SELECT phase 3 program were included. Key laboratory parameters and safety data were measured for UPA 15 and 30 mg once daily (QD), adalimumab (ADA) 40 mg every other week + methotrexate (MTX), and MTX monotherapy. Exposure-adjusted event rates (EAERs) of adverse events were calculated. Results A total of 3209 patients receiving UPA 15 mg QD (10 782.7 patient-years [PY]), 1204 patients receiving UPA 30 mg QD (3162.5 PY), 579 patients receiving ADA + MTX (1573.2 PY), and 314 patients receiving MTX monotherapy (865.1 PY) were included, representing up to 6.5 years of total exposure. Decreases in mean levels of hemoglobin, neutrophils, and lymphocytes, and increases in mean levels of liver enzymes and creatinine phosphokinase were observed with UPA, with grade 3 or 4 changes observed in some patients. Mean low- and high-density lipoprotein cholesterol ratios remained stable for patients receiving UPA 15 mg QD. EAERs of anemia and neutropenia occurred at generally consistent rates between UPA and active comparators (3.1–4.3 and 1.7–5.0 events [E]/100 PY across treatment groups, respectively). Rates of hepatic disorder were higher with MTX monotherapy, UPA 15 mg and UPA 30 mg (10.8, 9.7, and 11.0 E/100 PY, respectively) versus ADA + MTX (6.4 E/100 PY). Rates of lymphopenia were highest with MTX monotherapy (3.2 E/100 PY). Treatment discontinuations due to laboratory-related events were rare, occurring in 1.1% and 2.2% of patients treated with UPA 15 and 30 mg QD, respectively. Conclusions The results of this integrated long-term analysis of laboratory parameters continue to support an acceptable safety profile of UPA 15 mg QD for moderate-to-severe RA. |
| first_indexed | 2024-03-08T12:34:28Z |
| format | Article |
| id | doaj.art-7848bcb7d51248bd8d20a0519b6de718 |
| institution | Directory Open Access Journal |
| issn | 2198-6576 2198-6584 |
| language | English |
| last_indexed | 2024-03-08T12:34:28Z |
| publishDate | 2024-01-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Rheumatology and Therapy |
| spelling | doaj.art-7848bcb7d51248bd8d20a0519b6de7182024-01-21T12:34:52ZengAdis, Springer HealthcareRheumatology and Therapy2198-65762198-65842024-01-0111115717510.1007/s40744-023-00624-3Impact of Upadacitinib on Laboratory Parameters and Related Adverse Events in Patients with RA: Integrated Data Up to 6.5 YearsChristina Charles-Schoeman0Jon T. Giles1Nancy E. Lane2Ernest Choy3Daniel E. Furst4Jiří Vencovský5Anthony G. Wilson6Gerd R. Burmester7Derek Coombs8Sara K. Penn9Nasser Khan10Jillian B. Yee11Kassim Rahawi12Iain B. McInnes13University of CaliforniaColumbia UniversityUniversity of California DavisCREATE Centre, Cardiff UniversityDivision of Rheumatology, David Geffen School of Medicine, University of CaliforniaDepartment of Rheumatology, First Faculty of Medicine, Charles UniversityCenter for Arthritis Research, Conway Institute, University College DublinCharité–Universitätsmedizin BerlinAbbVie Inc.AbbVie Inc.AbbVie Inc.AbbVie Inc.AbbVie Inc.College of Medical, Veterinary, and Life Sciences, University of GlasgowAbstract Introduction Upadacitinib (UPA) is a Janus kinase inhibitor that has demonstrated efficacy in moderate-to-severe rheumatoid arthritis (RA) with an acceptable safety profile. We investigated laboratory parameter changes in UPA RA clinical trials. Methods Pooled data from six randomized trials in the SELECT phase 3 program were included. Key laboratory parameters and safety data were measured for UPA 15 and 30 mg once daily (QD), adalimumab (ADA) 40 mg every other week + methotrexate (MTX), and MTX monotherapy. Exposure-adjusted event rates (EAERs) of adverse events were calculated. Results A total of 3209 patients receiving UPA 15 mg QD (10 782.7 patient-years [PY]), 1204 patients receiving UPA 30 mg QD (3162.5 PY), 579 patients receiving ADA + MTX (1573.2 PY), and 314 patients receiving MTX monotherapy (865.1 PY) were included, representing up to 6.5 years of total exposure. Decreases in mean levels of hemoglobin, neutrophils, and lymphocytes, and increases in mean levels of liver enzymes and creatinine phosphokinase were observed with UPA, with grade 3 or 4 changes observed in some patients. Mean low- and high-density lipoprotein cholesterol ratios remained stable for patients receiving UPA 15 mg QD. EAERs of anemia and neutropenia occurred at generally consistent rates between UPA and active comparators (3.1–4.3 and 1.7–5.0 events [E]/100 PY across treatment groups, respectively). Rates of hepatic disorder were higher with MTX monotherapy, UPA 15 mg and UPA 30 mg (10.8, 9.7, and 11.0 E/100 PY, respectively) versus ADA + MTX (6.4 E/100 PY). Rates of lymphopenia were highest with MTX monotherapy (3.2 E/100 PY). Treatment discontinuations due to laboratory-related events were rare, occurring in 1.1% and 2.2% of patients treated with UPA 15 and 30 mg QD, respectively. Conclusions The results of this integrated long-term analysis of laboratory parameters continue to support an acceptable safety profile of UPA 15 mg QD for moderate-to-severe RA.https://doi.org/10.1007/s40744-023-00624-3JAK inhibitorLaboratory parametersRheumatoid arthritisUpadacitinib |
| spellingShingle | Christina Charles-Schoeman Jon T. Giles Nancy E. Lane Ernest Choy Daniel E. Furst Jiří Vencovský Anthony G. Wilson Gerd R. Burmester Derek Coombs Sara K. Penn Nasser Khan Jillian B. Yee Kassim Rahawi Iain B. McInnes Impact of Upadacitinib on Laboratory Parameters and Related Adverse Events in Patients with RA: Integrated Data Up to 6.5 Years Rheumatology and Therapy JAK inhibitor Laboratory parameters Rheumatoid arthritis Upadacitinib |
| title | Impact of Upadacitinib on Laboratory Parameters and Related Adverse Events in Patients with RA: Integrated Data Up to 6.5 Years |
| title_full | Impact of Upadacitinib on Laboratory Parameters and Related Adverse Events in Patients with RA: Integrated Data Up to 6.5 Years |
| title_fullStr | Impact of Upadacitinib on Laboratory Parameters and Related Adverse Events in Patients with RA: Integrated Data Up to 6.5 Years |
| title_full_unstemmed | Impact of Upadacitinib on Laboratory Parameters and Related Adverse Events in Patients with RA: Integrated Data Up to 6.5 Years |
| title_short | Impact of Upadacitinib on Laboratory Parameters and Related Adverse Events in Patients with RA: Integrated Data Up to 6.5 Years |
| title_sort | impact of upadacitinib on laboratory parameters and related adverse events in patients with ra integrated data up to 6 5 years |
| topic | JAK inhibitor Laboratory parameters Rheumatoid arthritis Upadacitinib |
| url | https://doi.org/10.1007/s40744-023-00624-3 |
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