Long-term Efficacy and Safety Following Switch Between Upadacitinib and Adalimumab in Patients with Rheumatoid Arthritis: 5-Year Data from SELECT-COMPARE

Join Jessica Farrell, PharmD, Clinical Pharmacist at Albany Med’s Division of Rheumatology and Professor at Albany College of Pharmacy and Health Sciences, for an in-depth review of a pivotal study published in Rheumatology and Therapy (March 2024) by Fleischmann et al. This RhAPP Journal Club session explores long-term clinical outcomes and safety data for rheumatoid arthritis (RA) patients switching between Upadacitinib (Rinvoq) and Adalimumab (Humira), based on findings from the SELECT-COMPARE Phase 3 study.

This analysis provides valuable insights into treat-to-target strategies in RA, particularly for patients who do not achieve optimal disease control with their initial therapy. The study examines remission and low disease activity (LDA) rates over 228 weeks post-switch, highlighting key outcomes for both non-responders and incomplete responders. Additionally, safety considerations—including herpes zoster risk, lymphopenia, and CPK elevations—are addressed to guide informed treatment transitions.

With ongoing debates over JAK inhibitors vs. TNF inhibitors in RA management, this discussion helps clinicians navigate treatment decisions, optimize patient outcomes, and engage in effective shared decision-making.

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