Discussion
This study reported the efficacy and safety of upadacitinib 15 mg QD in patients with AS who had an IR to bDMARDs (including TNFi or IL-17i therapy) through 52 weeks. The responses that were observed in the initial double-blind period of the study [The results of this study are in line with other studies where maintenance of efficacy over 1 year or longer has been observed in patients with AS treated with TNFi or IL-17i therapy, or another JAK inhibitor [The efficacy outcomes in this 1-year analysis in bDMARD-IR patients with AS are also consistent with previous reports for the SELECT-AXIS 1 study in bDMARD-naïve patients with AS and NSAID-IR [Efficacy outcomes at week 52 were generally similar across subgroups of patients who had discontinued prior bDMARD treatment due to lack of efficacy versus intolerance, and prior TNFi versus IL-17i exposure, and were consistent with the overall bDMARD-IR population reported in this study. Numerically lower responses were observed for some endpoints in the prior IL-17i exposure subgroup, but this subgroup had a limited number of patients so additional studies would be needed to further evaluate this.Treatment with upadacitinib was generally well tolerated throughout the study. No new safety risks were identified compared with the known safety profile of upadacitinib [The main limitations of this study are the lack of a comparator arm and the open-label nature of the study during the extension period. Defining a patient as having an IR due to a lack of efficacy or an intolerance to a bDMARD was based solely on the discretion of the investigators, although this is in line with the approach used in other studies [