Longer persistence seen with Upadacitinib versus tumor necrosis factor inhibitors in rheumatoid arthritis

by Elana Gotkine

edited by Gaby Clark, reviewed by Andrew Zinin

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Patients with rheumatoid arthritis (RA) have longer persistence with upadacitinib than tumor necrosis factor inhibitors (TNFi), according to a study published online June 23 in Rheumatology.

Denis Choquette, M.D., from the University of Montréal, and colleagues conducted an observational study involving 990 patients with RA from three registries (two Canadian and one Swiss) who initiated upadacitinib or TNFi between Jan. 1, 2020, and June 30, 2023, to examine real-world persistence and effectiveness.

The researchers found that compared with patients using TNFi, those using upadacitinib had a lower risk of discontinuing treatment (hazard ratio, 0.602), with no effect from previous exposure to advanced treatment. For both groups, improved persistence was associated with concomitant use of any conventional synthetic disease-modifying antirheumatic drugs (hazard ratios, 0.225 and 0.516 for upadacitinib and TNFi, respectively) and methotrexate (hazard ratios, 0.604 and 0.694, respectively). The proportion of patients who achieved Clinical Disease Activity Index low disease activity or remission was similar among those receiving upadacitinib or TNFi at six months (70.8 versus 61.0%) and 12 months (70.5 versus 75.2%).

"Upadacitinib's longer persistence was observed despite the upadacitinib-treated cohort having more severe disease profiles compared with those on other treatments, underscoring the efficacy of upadacitinib regardless of previous exposure to other advanced treatments," the authors write.

Several authors disclosed ties to the pharmaceutical industry.

Publication details

Denis Choquette et al, Persistence and effectiveness of upadacitinib and TNFi for rheumatoid arthritis using pooled data from Canadian and Swiss registries, Rheumatology (2026). DOI: 10.1093/rheumatology/keag301

Journal information: Rheumatology

Key medical concepts

Rheumatoid ArthritisupadacitinibTumor Necrosis Factor InhibitorsMethotrexate

Clinical categories

RheumatologyClinical pharmacology Who's behind this story?

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Citation: Longer persistence seen with Upadacitinib versus tumor necrosis factor inhibitors in rheumatoid arthritis (2026, July 6) retrieved 6 July 2026 from https://medicalxpress.com/news/2026-07-longer-persistence-upadacitinib-tumor-necrosis.html This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only.