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News
Upadacitinib keeps working — even after TNF inhibitors don't. A post hoc analysis of the SELECT-PsA 2 trial found that upadacitinib 15 mg once daily delivered strong, sustained disease control in psoriatic arthritis patients who had previously tried one TNF inhibitor. Notably, early pain scores at weeks 2 and 12 could predict whether patients would achieve minimal disease activity nearly three years later.
Upadacitinib keeps working — even after TNF inhibitors don't
For patients with psoriatic arthritis (PsA) who've already tried and failed a TNF inhibitor, the JAK inhibitor upadacitinib may offer a compelling next step. A post hoc analysis of the SELECT-PsA 2 randomized controlled trial evaluated 195 patients on upadacitinib 15 mg once daily versus placebo over 152 weeks, finding that clinical responses not only held up — they improved over time.
At week 24, upadacitinib significantly outperformed placebo across all key response measures, and patients who started on the drug maintained or built on those gains through week 152. Early pain response also emerged as a useful predictor of long-term outcomes.
By the Numbers
Why it matters: TNF inhibitor cycling — switching between similar drugs after one fails — is common but not always effective. These findings suggest upadacitinib could be a smarter pivot for PsA patients, potentially sparing them from repeated treatment failures.
