Real-World Upadacitinib Persistence and Clinical Outcomes Among Canadian Patients with Inflammatory Arthritis from a Patient Support Program: The UPRAISE Study

Rheumatoid arthritis (RA), psoriatic arthritis (PsA), and axial spondyloarthritis (axSpA) impact quality of life. Medication persistence is a key determinant of long-term effectiveness in chronic inflammatory diseases. This study evaluated treatment persistence, function, and program satisfaction among Canadian patients with RA, PsA, and axSpA receiving upadacitinib enrolled in the AbbVie Care patient support program (PSP). Data were collected from adults with RA, PsA, or axSpA enrolled in the Canadian PSP between January 2020 and July 2025. Demographic characteristics, first prescription fill rates, medication persistence, Health Assessment Questionnaire Disability Index (HAQ-DI) scores, and patient satisfaction with the PSP (subset of RA patients) were assessed. A total of 16,075 patients enrolled in the PSP were assessed (RA: N = 11,449; PsA: N = 2751; axSpA N = 1875). Over 90% of all patients filled their first upadacitinib prescription within 7 days. Among patients with RA, medication persistence was 73%, 63%, 56%, and 51% at 12, 24, 36, and 48 months, respectively. In PsA, persistence was 68%, 54%, and 47% at 12, 24, and 36 months, and with axSpA, persistence was 63% and 50% at 12 and 24 months. Patients with RA had a mean reduction from baseline in HAQ-DI of − 0.40 (N = 777; SD: 0.77; P < .001) and most patients (62%) achieved minimal clinically important difference (MCID; improvement ≥ 0.22[RA] or ≥ 0.35[PsA]), with 28% having normative values (HAQ-DI ≤ 0.25). Among patients with PsA, the mean reduction from baseline in HAQ-DI was − 0.65 (N = 153; SD: 0.66; P < 0.001); 73% of patients achieved MCID and 26% had normative values. Among 200 RA patients surveyed, nearly 90% were extremely/very satisfied with the PSP. High first prescription fill and long-term persistence rates were observed in patients with RA, PsA, and axSpA enrolled in a single national PSP, along with substantial improvements in physical function. Medication persistence-remaining on prescribed treatment over time-is critical to achieve long-term benefits for patients with chronic inflammatory diseases such as rheumatoid arthritis, psoriatic arthritis, and axial spondyloarthritis. Patient support programs are designed to help patients access their treatments and provide tools and resources to help them manage their condition and medications. In this large Canadian study, we found that most patients participating in the patient support program for upadacitinib filled their prescriptions and remained on treatment for extended periods, with high proportions still taking the medication 1–3 years after initiation. Sustained persistence translated to meaningful improvements in physical functioning for patients with rheumatoid arthritis and psoriatic arthritis, as measured by the Health Assessment Questionnaire Disability Index. A centralized patient support program facilitated rapid access and high satisfaction among participants. These findings underscore the importance of medication persistence itself as a relevant target to improve patient outcomes. Most patients achieved prompt treatment initiation, long-term therapy continuation, significant gain in physical function, and reported high levels of satisfaction with their participation in the patient support program.