4CPS-035 Persistence of upadacitinib treatment in its different indications

<h3>Background and Importance</h3> Upadacitinib, a Janus kinase (JAK) inhibitor, is widely used to treat chronic inflammatory conditions such as rheumatoid arthritis (RA), psoriatic arthritis (PsA), atopic dermatitis (AD), Crohn’s disease (CD), and ankylosing spondylitis (AS). Understanding treatment persistence – how long patients stay on therapy without discontinuation – is key to evaluating the drug’s real-world effectiveness and long-term benefits. Persistent treatment often indicates better disease control, while early discontinuation may suggest therapeutic failure or intolerance. <h3>Aim and Objectives</h3> The study aimed to determine the persistence of upadacitinib treatment across its various indications, including PsA, RA, AD, CD, and AS. <h3>Material and Methods</h3> This descriptive, observational, retrospective study involved adult patients treated with upadacitinib between January 2021 and January 2024. Data collected included patient demographics (sex, age), diagnosis, treatment line, start and end dates, and reasons for discontinuation (e.g., primary failure, secondary failure, intolerance, or loss of follow-up). Persistence was assessed at 12 and 24 months and analysed by condition and treatment line. Data were sourced from hospital pharmacy records (Savac) and clinical histories (Selene), and statistical analysis was performed using SPSS-Statistics version 23. <h3>Results</h3> A total of 72 patients were included, with an average age of 54 ± 15 years, and 69.4% (n=50) were women. Upadacitinib indications were: 8.3% PsA, 68.1% RA, 15.2% AD, 1.4% CD, and 6.9% AS. Most patients were in the sixth or later lines of treatment (37.5%). During the study, 41.7% (n=30) discontinued treatment, with an average duration of 7.4 ± 5.4 months. The discontinuation rate at 12 months was 34.7%, mainly due to secondary failure (43.3%), primary failure (20%), and intolerance (20%). Overall, 41.7% of patients maintained treatment for 12 months or more, and 18.1% for 24 months or longer. Persistence was highest in RA patients (15.7 ± 9.8 months) and those in earlier treatment lines (13.6 ± 9.5 months for second and third lines). <h3>Conclusion and Relevance</h3> Upadacitinib persistence is influenced by the specific condition and timing of treatment initiation. Higher persistence was observed in RA patients and those treated in earlier lines of therapy, which may reduce therapeutic failure. Further studies with larger sample sizes are needed to confirm the true persistence of upadacitinib across different conditions. <h3>References and/or Acknowledgements</h3> <h3>Conflict of Interest</h3> No conflict of interest