The Safety Profile of Upadacitinib in Patients with Rheumatoid Arthritis in Japan

Kunihiro Yamaoka (), Yoshiya Tanaka, Hideto Kameda, Nasser Khan, Nobuhito Sasaki, Masayoshi Harigai, Yanna Song, Ying Zhang and Tsutomu Takeuchi
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Kunihiro Yamaoka: Kitasato University School of Medicine
Yoshiya Tanaka: University of Occupational and Environmental Health
Hideto Kameda: Toho University (Ohashi Medical Center)
Nasser Khan: AbbVie Inc.
Nobuhito Sasaki: AbbVie GK
Masayoshi Harigai: Tokyo Women’s Medical University School of Medicine
Yanna Song: AbbVie Inc.
Ying Zhang: AbbVie Inc.
Tsutomu Takeuchi: Keio University School of Medicine

Drug Safety, 2021, vol. 44, issue 6, No 9, 722 pages

Abstract: Abstract Introduction Upadacitinib is a Janus kinase inhibitor with demonstrated efficacy in patients with rheumatoid arthritis (RA). Objective The aim of this study was to assess the long-term safety of upadacitinib in patients with active RA from Japan compared with global clinical trial populations. Methods Pooled data in patients enrolled from Japan (the ‘Japanese population’; SELECT-SUNRISE, SELECT-EARLY, and SELECT-MONOTHERAPY) were compared with that from global (Japan and ex-Japan) upadacitinib clinical trial populations and summarized descriptively. Results The Japanese population (mean age 57.0 years; mean RA duration 6.1 years) received upadacitinib 7.5 mg (n = 121), 15 mg (n = 126), and 30 mg (n = 124) once daily, while the global population (mean age 54.8 years; mean RA duration 9.1 years) received upadacitinib 6 mg twice daily/15 mg once daily (n = 2883) and 12 mg twice daily/30 mg once daily (n = 1375). Most patients were female (79.3%). The exposure-adjusted incidence rates (EAIRs) of serious adverse events in the Japanese population were 11.5, 12.2, and 21.2 per 100 patient-years (PY) with upadacitinib 7.5, 15, and 30 mg, respectively. Herpes zoster rates were higher in the Japanese population (7.8, 12.4, and 16.7 per 100 PY with 7.5, 15, and 30 mg, respectively) versus global populations (3.7 and 7.0 per 100 PY with 15 and 30 mg, respectively). Prior herpes zoster was a significant risk factor for herpes zoster. Conclusions The safety profile of upadacitinib was generally similar between Japanese and global RA populations, except for higher EAIRs for serious adverse events and infections, including herpes zoster, in the Japanese population. Trial Registration Numbers SELECT-EARLY: NCT02706873; SELECT-NEXT: NCT02675426; SELECT-COMPARE: NCT02629159; SELECT-MONOTHERAPY: NCT02706951; SELECT-BEYOND: NCT02706847; SELECT-SUNRISE: NCT02720523; BALANCE I: NCT01960855; BALANCE II: NCT02066389.

Date: 2021
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DOI: 10.1007/s40264-021-01067-x

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