Comparative treatment persistence of upadacitinib vs. tofacitinib in psoriatic arthritis: a multicenter observational study from the BIRRA cohort - Summary - MDSpire

Comparative treatment persistence of upadacitinib vs. tofacitinib in psoriatic arthritis: a multicenter observational study from the BIRRA cohort

  • By

  • Alessandro Conforti

  • Martina Gentile

  • Valerio Cipolloni

  • Linda Lucchetti

  • Marta Priora

  • Andrea Becciolini

  • Eleonora Celletti

  • Miriam Di Penta

  • Alberto Lo Gullo

  • Marino Paroli

  • Elena Bravi

  • Romina Andracco

  • Valeria Nucera

  • Francesca Ometto

  • Federica Lumetti

  • Antonella Farina

  • Matteo Colina

  • Viviana Ravagnani

  • Palma Scolieri

  • Maddalena Larosa

  • Elisa Visalli

  • Olga Addimanda

  • Rosetta Vitetta

  • Alessandro Volpe

  • Alessandra Bezzi

  • Francesco Girelli

  • Aldo Biagio Molica Colella

  • Rosalba Caccavale

  • Eleonora Di Donato

  • Giuditta Adorni

  • Daniele Santilli

  • Gianluca Lucchini

  • Eugenio Arrigoni

  • Emanuela Sabatini

  • Ilaria Platè

  • Natalia Mansueto

  • Aurora Ianniello

  • Enrico Fusaro

  • Maria Chiara Ditto

  • Vincenzo Bruzzese

  • Dario Camellino

  • Gerolamo Bianchi

  • Francesca Serale

  • Rosario Foti

  • Giorgio Amato

  • Francesco De Lucia

  • Ylenia Dal Bosco

  • Roberta Foti

  • Massimo Reta

  • Alessia Fiorenza

  • Guido Rovera

  • Antonio Marchetta

  • Maria Cristina Focherini

  • Fabio Mascella

  • Simone Bernardi

  • Gilda Sandri

  • Dilia Giuggioli

  • Carlo Salvarani

  • Veronica Franchina

  • Francesco Molica Colella

  • Giulio Ferrero

  • Mirco Magnani

  • Marta Maset

  • Camilla Mazzanti

  • Gianluca Santoboni

  • Claudio Angrisani

  • Massimiliano De Simone

  • Bernd Raffeiner

  • Simone Parisi

  • Alarico Ariani

  • July 8, 2026

Share

Objective:

To compare real-world treatment persistence between upadacitinib and tofacitinib in patients with psoriatic arthritis and identify predictors of treatment discontinuation.

Approach:
  • Study Design: Retrospective, multicenter, observational study using data from the Italian BIRRA cohort.
  • Participants: 181 PsA patients treated with UPA (n = 124) and TOFA (n = 57) from 34 rheumatology centers.
  • Data Collection: Baseline demographics, treatment details, and disease activity (DAPSA) were collected.
  • Analysis: Treatment persistence evaluated using Kaplan-Meier survival analysis; predictors identified via Cox proportional hazards models.
Key Findings:
  • Retention rates at 6, 12, and 18 months were 86%, 68%, and 54% for UPA and 78%, 60%, and 60% for TOFA (p = 0.7). Concomitant csDMARD therapy (HR: 1.92; 95% CI: 1.04–3.54; p = 0.037) and later-line treatment (HR: 1.17; 95% CI: 1.01–1.35; p = 0.034) were associated with higher discontinuation risk. No statistically significant differences in persistence between UPA and TOFA after adjustment.
Interpretation:

PsA treatment retention may be influenced more by patient- and treatment-related factors than by the specific JAK inhibitor prescribed.

Limitations:
  • The study is retrospective and observational, which may introduce biases, including selection bias and information bias. Limited generalizability due to the specific cohort and setting.
Conclusion:

UPA demonstrated slightly longer persistence than TOFA, though the difference was not statistically significant after adjustment.

Original Source(s)

Comparative treatment persistence of upadacitinib vs. tofacitinib in psoriatic arthritis: a multicenter observational study from the BIRRA cohort

  • by Alessandro Conforti, Martina Gentile, Valerio Cipolloni, Linda Lucchetti, Marta Priora, Andrea Becciolini, Eleonora Celletti, Miriam Di Penta, Alberto Lo Gullo, Marino Paroli, Elena Bravi, Romina Andracco, Valeria Nucera, Francesca Ometto, Federica Lumetti, Antonella Farina, Matteo Colina, Viviana Ravagnani, Palma Scolieri, Maddalena Larosa, Elisa Visalli, Olga Addimanda, Rosetta Vitetta, Alessandro Volpe, Alessandra Bezzi, Francesco Girelli, Aldo Biagio Molica Colella, Rosalba Caccavale, Eleonora Di Donato, Giuditta Adorni, Daniele Santilli, Gianluca Lucchini, Eugenio Arrigoni, Emanuela Sabatini, Ilaria Platè, Natalia Mansueto, Aurora Ianniello, Enrico Fusaro, Maria Chiara Ditto, Vincenzo Bruzzese, Dario Camellino, Gerolamo Bianchi, Francesca Serale, Rosario Foti, Giorgio Amato, Francesco De Lucia, Ylenia Dal Bosco, Roberta Foti, Massimo Reta, Alessia Fiorenza, Guido Rovera, Antonio Marchetta, Maria Cristina Focherini, Fabio Mascella, Simone Bernardi, Gilda Sandri, Dilia Giuggioli, Carlo Salvarani, Veronica Franchina, Francesco Molica Colella, Giulio Ferrero, Mirco Magnani, Marta Maset, Camilla Mazzanti, Gianluca Santoboni, Claudio Angrisani, Massimiliano De Simone, Bernd Raffeiner, Simone Parisi, Alarico Ariani

  • July 8, 2026

Related Content

A clinical care pathway for managing pregnancy in patients with inflammatory arthritis

Mandatory Training Modules Deserve a Harder Look

A JAMA Viewpoint argues that 4 million physician-hours spent on compliance modules each year warrants institutional reassessment.

Evaluation of serum TWEAK levels and treatment response in psoriasis and psoriatic arthritis: a prospective comparative case–control study of adalimumab and methotrexate