Upadacitinib bests adalimumab for pain relief in rheumatoid arthritis

These post hoc analyses of the SELECT-COMPARE and SELECT-PsA 1 phase 3 trials show that in rheumatoid arthritis (RA) with active inflammation, upadacitinib provided greater Patient's Global Assessment of pain (PtGA) improvement at week 12 vs. adalimumab or placebo (–42.9 vs. –34.7 and –33.1; p<0.05), with similar effects by week 26. For psoriatic arthritis (PsA), PtGA improvement was greater with upadacitinib at weeks 12 and 24 (–2.7 and –3.8) vs. placebo (–1.8 and –2.8; p<0.05 and p<0.001) and similar to adalimumab (–2.8 and –3.6). Direct and total pain effects favored upadacitinib over placebo and exceeded adalimumab in RA; both agents outperformed placebo in PsA.

Clinical takeaway: For RA patients with residual pain despite controlled inflammation, consider upadacitinib to target both inflammatory and non‑inflammatory pain mechanisms.

Source:

Taylor PC, et al. (2026, January 8). RMD Open. Effects of upadacitinib or adalimumab on pain in rheumatoid arthritis and psoriatic arthritis: results from randomised phase 3 studies. https://pubmed.ncbi.nlm.nih.gov/41506743/