Reconstitution of high-grade serous ovarian carcinoma from primary fallopian tube secretory epithelial cells.

OBJECTIVES

Evidence on the long-term real-world effectiveness and safety of upadacitinib in TNFi-refractory psoriatic arthritis (PsA) remains limited. Our aim was to evaluate the real-world effectiveness and safety of upadacitinib in PsA patients with prior TNF-inhibitor failure.

METHODS

This retrospective study included 47 patients with PsA (mean age 46.7 ± 10.1 years, 59.6% female, mean disease duration 9.8 ± 7.4 years). Patients received upadacitinib 15 mg daily and were followed up to 56 weeks. Clinical activity (DAPSA, BASDAI, ASDAS-CRP), ACR responses, PASI, patient-reported outcomes, and adverse events were assessed at baseline, week 12, 24, and 56. Intention-to-treat (ITT) analysis was the primary approach.

RESULTS

Axial involvement was present in 74.5% and enthesitis in 85.1%. At week 12, ITT ACR20/50/70 response rates were 63.8%, 55.3%, and 31.9%, respectively. By week 56, ITT responses were 61.7%, 59.6%, and 51.1%. Significant improvements were also observed in DAPSA, BASDAI, ASDAS-CRP, and PASI scores (all p<0.001), with resolution of enthesitis in most patients. Adverse events occurred in 23.4% of patients, with 10.6% leading to discontinuation. Safety outcomes were consistent with the established profile of upadacitinib, with no new safety signals identified.

CONCLUSIONS

Upadacitinib demonstrated sustained efficacy across musculoskeletal and skin domains in PsA patients with prior inadequate response to TNF inhibitors, with a safety profile consistent with previous reports. These findings support its role as an effective treatment option in this difficult-to-treat population.