Upatinib/Revo reduces non-nociceptive pain in axSpA

Treatment with upadacitinib is associated with improvements in non-nociceptive pain and reductions in both neuropathic and nociceptive pain scores in patients with axial spondyloarthritis (axSpA), according to published findings.

OralThe Janus kinase inhibitor Upadatinib has previously been shown to be beneficial in reducing inflammation and nociceptive pain in axSpA. However, patients may also experience non-nociceptive pain, including nociceptive pain and neuropathic pain, which may lead to ongoing symptoms such as sleep disturbance, anxiety, and depression. Therefore, researchers conducted a post hoc analysis of a 12-month, multinational, non-interventional, observational study to assess how upacitinib affected non-nociceptive pain scores.

The analysis was conducted using interim data from the UPSTAND study after patients completed at least Week 12. Non-nociceptive pain was measured using the Pain Detection Questionnaire for Neuropathic Pain; the Widespread Pain Index (WPI) and Symptom Severity Score (SSS) were used to quantify delayed pain.

The percentage of patients in each pain severity group is reported at baseline, Week 12, and Week 24 (if available). Associations between pain severity and disease activity, sleep quality, anxiety, and depression were analyzed. Nonnociceptive pain is associated with residual symptoms, sleep disturbance, anxiety/depressive symptoms, and fatigue.

At baseline, 48.9% of patients were highly likely to experience delayed pain (WPI > 6), which dropped to 27.3% at week 12 and 24.1% at week 24. Similarly, the number of patients meeting criteria for fibromyalgia (WPI+SSS) decreased from 48.7% at baseline to 27.2% at week 12 and 22.8% at week 24. The proportion of patients with a high likelihood of neuropathic pain (pain test >18) decreased from 26.2% at baseline to 11.9% at week 12.

Treatment with upadacitinib was associated with a reduction in neuropathic and nocturnal pain over time. By week 12, the proportion of patients in the milder pain group increased, while the percentage of patients in the more severe pain group and the number of patients meeting criteria for fibromyalgia decreased.

No.Non-nociceptive pain at 12 weeks was associated with residual symptoms including anxiety, depression and poor sleep quality. Compared with patients with persistent nonnociceptive pain, patients with a lower likelihood of developing nociceptive or neuropathic pain at week 12 were more likely to achieve disease control, including low disease activity, better sleep quality, and normal anxiety and depression scores.

Additionally, improvements in overall and nocturnal back pain, fatigue, and function from baseline to week 12 were greater in patients with a lower likelihood of nonnociceptive pain, whereas improvements were smaller in patients with higher nociceptive or neuropathic pain scores.

The study authors concluded:“Non-nociceptive pain is associated with residual symptoms, sleep disturbance, anxiety/depressive symptoms, and fatigue.

Reference materials:https://www.rheumatologyadvisor.com/reports/upa-may-reduce-non-nociceptive-pain-in-axspa/