Are the goals of therapy achievable in patients with rheumatoid arthritis receiving upadacitinib in real clinical practice?

Abstract

The aim of the study was to evaluate the effectiveness of UPA in RA patients in real clinical practice after 3 and 6 months of therapy.Material and methods. The study included 63 RA patients with high activity of the disease. Activity was assessed according to the DAS28 (ESR), DAS28 (CR P), SDAI, CDAI; functional ability to HAQ; quality of life to the EQ-5D; disease activity according to the patient’s RAPID-3 index; the level of depression and anxiety to the HADS scale. The effectiveness of therapy was evaluated after 3 (n=45) and 6 (n=31) months of UPA therapy.Results. Remission or low activity of the disease by 3 months of therapy was achieved by most patients: remission of 69.8% of patients, low activity of the disease – 16.3% of patients. Moderate or high activity persisted in 13.9% of patients. By the 6th month of UPA therapy, the number of remissions reached 90% , low activity – 3.3%, moderate activity persisted in 6.7% of patients, high activity of the disease was not in any patient. 20% improvement in function was achieved in 71.8% of patients by the 3rd month of therapy and in 77.8% – by the 6th month of treatment; the difference in average HAQ values by the 3rd month of therapy was 0.38 points, by the 6th month – 0.58 points. After 3 months of follow-up, 31.1% of patients continued taking GC, by 6 months – 24.2%. The dose of GC was reduced from an average of 7.23 mg/d to 5.6 mg/d. The percentage of patients requiring NSAIDs decreased from 95.2% to 35.6% and 33.3%, respectively. DMARDs continued to be received by 75.6% of patients by 3 months and 69.7% by 6 months of follow-up.Conclusion. Achieving remission or low activity of the disease in patients with RA receiving UPA in real clinical practice is possible in most patients. A rapid decrease in inflammatory activity is accompanied by a significant improvement in the functional state and quality of life of patients. UPA therapy reduces the need for the use of NSAIDs and reduces the dose of GC in a third of patients.