ABS0537 EARLY IMPROVEMENT OF PAIN, LONG-TERM DISEASE CONTROL, AND QUALITY OF LIFE OUTCOMES IN PATIENTS WITH PSORIATIC ARTHRITIS TREATED WITH UPADACITINIB

Background: Severe musculoskeletal manifestations of PsA, particularly joint pain, can result in reduced physical function, decreased quality of life, and progressive and irreversible joint damage [1, 2]. Upadacitinib (15mg; UPA15), an oral JAK inhibitor, has shown to rapidly and meaningfully reduce pain in patients with active PsA and inadequate response (IR) to non-biologic DMARDs (non-bDMARD-IR, including csDMARDs or apremilast) or biologic DMARDs (bDMARD-IR) [3]. However, there is limited evidence of how rapid pain improvement impacts long-term disease control and quality of life. Objectives: This analysis reports the improvement in pain by baseline pain severity and the impact of early pain improvement on long-term, stringent disease control targets and patient-reported outcomes in patients with PsA treated with UPA15 through 152 wks. Methods: In this post hoc analysis, patients randomized to UPA15 in the phase 3 trials SELECT-PsA 1 (N=429; non-bDMARD-IR patients) and SELECT-PsA 2 (N=211; bDMARD-IR patients) were analyzed separately [4, 5]. Mean pain scores (as observed, AO) over 152 wks were calculated in patients with mild/moderate (0-3/4-6) and severe (7-10) baseline pain severity (numeric rating scale, NRS: 0-10). Patients were also stratified by achievement/nonachievement of early pain improvement (≥30% at wk 2 and ≥30/50/70% at wk 12); for each group, achievement of MDA, DAPSA low disease activity (LDA; ≤14), or pain ≤1.5 (NRS) (all reported as nonresponder imputation) and mean change from baseline in SF-36 mental component summary (SF-36 MCS; reported AO) was calculated at wk 152. Results: For patients with severe pain at baseline, mean pain scores rapidly decreased to moderate levels in the first 2 wks of treatment with UPA15, with additional reductions and achievement of mild/moderate levels by wk 152 in both non-bDMARD-IR (wk 152 mean: 3.3) and bDMARD-IR patients (3.8) (Figure 1). For patients with mild/moderate pain at baseline, mean pain scores decreased and were maintained to mild levels through wk 152 in non-bDMARD-IR (2.0) and bDMARD-IR (2.8) patients. In both studies, a larger proportion of patients with early pain improvements achieved MDA, DAPSA LDA, and pain ≤1.5 at wk 152, compared to patients without early pain improvements (Figure 2). Additionally, bDMARD-IR patients with early pain improvements reported greater improvements in SF-36 MCS score at wk 152 compared to those without early improvements, with smaller differences observed in non-bDMARD-IR patients. Conclusion: In non-bDMARD-IR and bDMARD-IR PsA patients, reductions in pain score occurred rapidly and were maintained through 152 wks of treatment with UPA15, regardless of pain severity at baseline. More patients with early pain improvements achieved long-term, stringent disease control targets and quality of life outcomes compared to patients without early pain improvements, suggesting that rapid pain improvement may be a positive indicator of long-term disease control. REFERENCES: [1] Coates LC, et al. Health Qual Life Outcomes. 2020;18:173. [2] Ogdie A, et al. Rheum & Therapy. 2021;9:735-51. [3] McInnes IB, et al. RMD Open . 2022;8:e002049. [4] McInnes, IB et al. N Engl J Med. 2021;384:1227-39. [5] Mease PJ, et al. Ann Rheum Dis. 2021;80:312-20. Acknowledgements: AbbVie funded these trials (NCT03104400; NCT03104374) and participated in the study design, research, analysis, data collection, interpretation of data, reviewing, and approval of the publication. All authors had access to relevant data and participated in the drafting, review, and approval of this publication. No honoraria or payments were made for authorship. Medical writing support was provided by Kathleen E. Gordon, PhD of AbbVie. Editorial support was provided by Angela T. Hadsell of AbbVie. Disclosure of Interests: Peter C. Taylor AbbVie, AbbVie, Biogen, Eli Lilly, Fresenius, Galapagos, Gilead Sciences, GlaxoSmithKline, Janssen, Nordic Pharma, Pfizer Inc, Roche, UCB, Sanofi, Immunovant, Moonlake, Galapagos, Lihi Eder AbbVie, UCB, Eli Lilly, Novartis, Fresenius Kabi, Janssen, BMS, and Pfizer, Yael Klionsky Janssen and AstraZeneca, Eli Lilly, MediQ, Amgen, Abbvie and Aztrazeneca, Fabian Proft AMGEN, AbbVie, BMS, Celgene, Janssen, MSD, Novartis, Pfizer, Roche, UCB, Medscape, Galapagos, Hexal, Novartis, Eli Lily, UCB, Thomas Iyile AbbVie Inc., Erin Mancl AbbVie Inc., Priscila Nakasato AbbVie Inc., Xiaolan Ye AbbVie Inc., Limei Zhou AbbVie Inc., Philip J. Mease AbbVie, Acelyrin, Amgen, Bristol Myers, Inmagene, Janssen, Lilly, Moonlake, Novartis, Pfizer, and UCB. © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

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