Upadacitinib and Pain in RA, PsA

Mediation analysis suggests direct and indirect effects on pain reduction in rheumatoid and psoriatic arthritis.

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Upadacitinib is more effective than adalimumab or placebo in reducing pain in rheumatoid arthritis patients, regardless of inflammation status.
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In psoriatic arthritis, upadacitinib shows similar pain improvement to adalimumab, according to post hoc analyses of two phase III trials.
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Patients with rheumatoid arthritis on upadacitinib had greater rates of inflammation attenuation compared to those on adalimumab or placebo.
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Pain reduction with upadacitinib occurs both with and without inflammation control, indicating its direct effects on pain.
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The study's limitations include its post hoc design and potential inaccuracies in inflammation indices used for assessment.

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