Evidence map›Paper›PMID 40875187›Full record

ArticleAdvances in therapy2025

Safety Profile of Upadacitinib: Descriptive Analysis in Over 27,000 Patient-Years Across Rheumatoid Arthritis, Psoriatic Arthritis, Axial Spondyloarthritis, Atopic Dermatitis, and Inflammatory Bowel Disease.

Gerd R Burmester, Atul Deodhar, Alan D Irvine, Remo Panaccione, Kevin L Winthrop, Ruth Ann Vleugels, Gweneth Levy, Smitha Suravaram, Hannah Palac, Lani Wegrzyn and 3 more

15 registry-linked trialsAbstract read
In one paragraph

Article in Advances in therapy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 15 registered trials, which are not on this map. Cited by 24 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02629159 phase3active not recruitingnot on this map

A Phase 3, Randomized, Double-Blind Study Comparing Upadacitinib (ABT-494) to Placebo and to Adalimumab in Subjects With Moderately to Severely Active Rheumatoid Arthritis Who Are on a Stable Background of Methotrexate (MTX) and Who Have an Inadequate Response to MTX (MTX-IR)

TypeinterventionalSponsorAbbVieRan2015 to 2027Enrolled1,629ConditionsRheumatoid ArthritisArmsPlacebo for Adalimumab, Adalimumab, Placebo for Upadacitinib, Upadacitinib
NCT02675426 phase3completednot on this map

A Phase 3, Randomized, Double-Blind Study Comparing Upadacitinib (ABT-494) to Placebo in Subjects With Moderately to Severely Active Rheumatoid Arthritis Who Are on a Stable Dose of Conventional Synthetic Disease-Modifying Anti-Rheumatic Drugs (csDMARDs) and Have an Inadequate Response to csDMARDs

TypeinterventionalSponsorAbbVieRan2015 to 2022Enrolled661ConditionsRheumatoid ArthritisArmsPlacebo, Upadacitinib
NCT02706847 phase3completednot on this map

A Phase 3, Randomized, Double-Blind Study Comparing Upadacitinib (ABT-494) to Placebo on Stable Conventional Synthetic Disease-Modifying Anti-Rheumatic Drugs (csDMARDs) in Subjects With Moderately to Severely Active Rheumatoid Arthritis With Inadequate Response or Intolerance to Biologic DMARDs (bDMARDs)

TypeinterventionalSponsorAbbVieRan2016 to 2022Enrolled499ConditionsRheumatoid ArthritisArmsPlacebo, Upadacitinib
NCT02706873 phase3completednot on this map

A Phase 3, Randomized, Double-Blind Study Comparing Upadacitinib (ABT-494) Once Daily Monotherapy to Methotrexate (MTX) Monotherapy in MTX-Naïve Subjects With Moderately to Severely Active Rheumatoid Arthritis

TypeinterventionalSponsorAbbVieRan2016 to 2022Enrolled1,002ConditionsRheumatoid ArthritisArmsPlacebo to Upadacitinib, Methotrexate, Placebo to Methotrexate, Upadacitinib
NCT02706951 phase3completednot on this map

A Phase 3, Randomized, Double-Blind Study Comparing Upadacitinib (ABT-494) Monotherapy to Methotrexate (MTX) in Adults With Moderately to Severely Active Rheumatoid Arthritis With Inadequate Response to MTX

TypeinterventionalSponsorAbbVieRan2016 to 2022Enrolled648ConditionsRheumatoid ArthritisArmsMethotrexate, Upadacitinib, Placebo Upadacitinib, Placebo Methotrexate
NCT02819635 phase2 / phase3completednot on this map

A Multicenter, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate the Safety and Efficacy of Upadacitinib (ABT-494) for Induction and Maintenance Therapy in Subjects With Moderately to Severely Active Ulcerative Colitis

TypeinterventionalSponsorAbbVieRan2016 to 2021Enrolled1,302ConditionsUlcerative Colitis (UC)ArmsPlacebo, Upadacitinib
NCT03086343 phase3completednot on this map

A Phase 3, Randomized, Active-Controlled, Double-Blind Study Comparing Upadacitinib (ABT-494) to Abatacept in Subjects With Moderately to Severely Active Rheumatoid Arthritis With Inadequate Response or Intolerance to Biologic DMARDs (bDMARDs) on Stable Conventional Synthetic Disease Modifying Anti-Rheumatic Drugs (csDMARDs)

TypeinterventionalSponsorAbbVieRan2017 to 2023Enrolled657ConditionsRheumatoid Arthritis (RA)ArmsAbatacept, Placebo for abatacept (0.9% Sodium Chloride Injection or Solution for Infusion), Upadacitinib, Placebo for upadacitinib
NCT03104374 phase3completednot on this map

A Phase 3, Randomized, Double-Blind, Study Comparing Upadacitinib (ABT-494) to Placebo in Subjects With Active Psoriatic Arthritis Who Have a History of Inadequate Response to at Least One Biologic Disease Modifying Anti-Rheumatic Drug (bDMARD)

TypeinterventionalSponsorAbbVieRan2017 to 2024Enrolled642ConditionsPsoriatic ArthritisArmsPlacebo, Upadacitinib
NCT03104400 phase3completednot on this map

A Phase 3, Randomized, Double-Blind, Study Comparing Upadacitinib (ABT-494) to Placebo and to Adalimumab in Subjects With Active Psoriatic Arthritis Who Have a History of Inadequate Response to at Least One Non-Biologic Disease Modifying Anti-Rheumatic Drug (DMARD) - SELECT - PsA 1

TypeinterventionalSponsorAbbVieRan2017 to 2024Enrolled1,705ConditionsPsoriatic ArthritisArmsAdalimumab, Upadacitinib, Placebo to Upadacitinib, Placebo to Adalimumab
NCT03178487 phase2completednot on this map

A Multicenter, Randomized, Double-Blind, Placebo-Controlled Study Evaluating the Safety and Efficacy of Upadacitinib in Subjects With Active Ankylosing Spondylitis

TypeinterventionalSponsorAbbVieRan2017 to 2022Enrolled187ConditionsAnkylosing Spondylitis (AS)ArmsUpadacitinib, Placebo
NCT03345823 phase3active not recruitingnot on this map

A Multicenter, Randomized, Double-Blind, Placebo-Controlled Maintenance and Long-Term Extension Study of the Efficacy and Safety of Upadacitinib (ABT-494) in Subjects With Crohn's Disease Who Completed the Studies M14-431 or M14-433

TypeinterventionalSponsorAbbVieRan2018 to 2027Enrolled747ConditionsCrohn's DiseaseArmsUpadacitinib, Placebo for Upadacitinib
NCT03568318 phase3active not recruitingnot on this map

A Phase 3 Randomized, Placebo-Controlled, Double-Blind Study to Evaluate Upadacitinib in Combination With Topical Corticosteroids in Adolescent and Adult Subjects With Moderate to Severe Atopic Dermatitis

TypeinterventionalSponsorAbbVieRan2018 to 2030Enrolled1,533ConditionsAtopic DermatitisArmsPlacebo, Upadacitinib, Topical corticosteroids (TCS)
NCT03569293 phase3completednot on this map

A Phase 3 Randomized, Placebo-Controlled, Double-Blind Study to Evaluate Upadacitinib in Adolescent and Adult Subjects With Moderate to Severe Atopic Dermatitis

TypeinterventionalSponsorAbbVieRan2018 to 2025Enrolled912ConditionsAtopic DermatitisArmsPlacebo for Upadacitinib, Upadacitinib
NCT03607422 phase3completednot on this map

A Phase 3 Randomized, Placebo-Controlled, Double-Blind Study to Evaluate Upadacitinib in Adolescent and Adult Subjects With Moderate to Severe Atopic Dermatitis

TypeinterventionalSponsorAbbVieRan2018 to 2025Enrolled912ConditionsAtopic DermatitisArmsPlacebo for Upadacitinib, Upadacitinib
NCT04169373 phase3completednot on this map

A Phase 3 Randomized, Placebo-Controlled, Double-Blind Program to Evaluate Efficacy and Safety of Upadacitinib in Adult Subjects With Axial Spondyloarthritis Followed by a Remission-Withdrawal Period

TypeinterventionalSponsorAbbVieRan2019 to 2025Enrolled734ConditionsSpondyloarthritisArmsUpadacitinib, Placebo
3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Trial
  3. Review
  4. Upadacitinib Restrains the Pathogenic Fitness of CD4Advanced science (Weinheim, Baden-Wurttemberg, Germany) · 2026
    Article
  5. Article
  6. Article
  7. Targeting the non-coding RNA-PANoptosis axis: a novel frontier in disease diagnosis and therapy.Apoptosis : an international journal on programmed cell death · 2026
    Review
  8. Review
  9. Article
  10. Article
  11. Article
  12. Review
  13. Review
  14. Review
  15. Article
  16. Article
  17. Review
  18. Article
  19. Review
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors.

Gerd R BurmesterDepartment of Rheumatology and Clinical Immunology, Freie Universität Berlin and Humboldt-Universität zu Berlin, Charité Universitätsmedizin Berlin, Berlin, Germany. gerd.burmester@charite.de.ORCID http://orcid.org/0000-0001-7518-1131
Atul DeodharDivision of Arthritis and Rheumatic Diseases, Oregon Health and Science University, Portland, OR, USA.
Alan D IrvineDepartment of Clinical Medicine, Trinity College Dublin, Dublin, Ireland.
Remo PanaccioneInflammatory Bowel Disease Unit, Division of Gastroenterology and Hepatology, University of Calgary, Calgary, AB, Canada.
Kevin L WinthropDivision of Infectious Diseases, School of Medicine, School of Public Health, Oregon Health and Science University, Portland, OR, USA.
Ruth Ann VleugelsDepartment of Dermatology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
Gweneth LevyAbbVie Inc., North Chicago, IL, USA.
Smitha SuravaramAbbVie Inc., North Chicago, IL, USA.
Hannah PalacAbbVie Inc., North Chicago, IL, USA.
Lani WegrzynAbbVie Inc., North Chicago, IL, USA.
Sharanya FordAbbVie Inc., North Chicago, IL, USA.
Sebastian MeerweinAbbVie Deutschland GmbH & Co. KG, Ludwigshafen, Germany.
Emma Guttman-YasskyDepartment of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionWe report the long-term safety of upadacitinib (oral, selective, and reversible Janus kinase inhibitor) in rheumatoid arthritis (RA), psoriatic arthritis (PsA), ankylosing spondylitis (AS), non-radiographic axial spondyloarthritis (nr-axSpA), atopic dermatitis (AD), Crohn's disease (CD), and ulcerative colitis (UC).

methodsData were analyzed from 16 studies (data cutoff August 15, 2024). Each treatment group was pooled across studies within each indication. Active comparator arms included adalimumab (RA/PsA) and methotrexate (RA). Treatment-emergent adverse events (TEAEs) were reported as exposure-adjusted incidence rates per 100 patient-years (n/100 PY).

resultsThis analysis included 8632 (RA, n = 3209; PsA, n = 907; AS, n = 596; nr-axSpA, n = 286; AD, n = 2683; CD, n = 450; UC, n = 501) upadacitinib-treated patients over 27,164.2 patient-years (range 199.4-12,315.8 PY across indications). Rates (n/100 PY) of any TEAEs ranged from 112.0 (AS) to 401.1 (RA). Most frequently reported TEAEs included COVID-19, upper respiratory tract infection, nasopharyngitis, herpes zoster, urinary tract infection, and acne (primarily patients with AD). Serious TEAEs ranged from 4.5 (AD) to 11.0 (UC), and those leading to discontinuation ranged from 2.9 (AS) to 8.3 (UC). TEAEs leading to death ranged from 0 (nr-axSpA, UC) to 0.7 (RA). Among upadacitinib-treated patients across indications, rates of adverse events of special interest ranged from 1.3 to 4.6 (serious infection), 2.4-6.6 (herpes zoster), 0.2-0.9 (malignancy excluding nonmelanoma skin cancer [NMSC]), 0-1.4 (NMSC), 0-0.5 (major adverse cardiovascular event [MACE]), 0-0.9 (venous thromboembolism [VTE]), and 0-9.2 (elevated creatine kinase). In RA and PsA, herpes zoster, NMSC, and elevated creatine kinase rates were numerically higher with upadacitinib vs active comparators. Serious infection, herpes zoster, malignancy (excluding NMSC), NMSC, MACE, and VTE rates remained stable over time.

conclusionThis descriptive analysis indicates a long-term safety profile of upadacitinib consistent with previous reports, further supporting long-term treatment of chronic diseases with upadacitinib. Variations in TEAE rates across indications likely reflected differences in populations and underlying comorbidities.

trial registrationClinicalTrials.gov identifiers NCT02675426, NCT02706951, NCT02706847, NCT02629159, NCT02706873, NCT03086343, NCT03104374, NCT03104400, NCT03178487, NCT04169373, NCT03569293, NCT03568318, NCT03607422, NCT03345823, NCT02819635.

Indexed as

Arthritis, RheumatoidDermatitis, AtopicHeterocyclic Compounds, 3-RingInflammatory Bowel DiseasesJanus Kinase InhibitorsAdultArthritis, PsoriaticAxial SpondyloarthritisClinical Trials as TopicFemaleHumansMaleMiddle AgedHeterocyclic Compounds, 3-RingJanus Kinase InhibitorsupadacitinibArthritisAtopic dermatitisAxial spondyloarthritisInfectionsInflammatory bowel diseasesMajor adverse cardiovascular eventsMalignancyRheumatoidSafetyUpadacitinib

Identifiers

PMID40875187
PMCPMC12474609

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

and 9 more above

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.