Professor of Rheumatology and Deputy Head of the Department of Rheumatology and Clinical Immunology, Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin

Frank Buttgereit, MD

Cutting Down on Glucocorticoids in Giant Cell Arteritis With Upadacitinib, with Frank Buttgereit, MD

New data continue to support upadacitinib15 mg’s benefit for people with giant cell arteritis (GCA) with a shorter glucocorticoid (GC) tapering over placebo with a longer taper, with low rates of serious infection.

These findings, from the pivotal SELECT-GCA trial, were presented at the 

European Alliance of Associations for Rheumatology (EULAR) Congress 2025 

in Barcelona, Spain, taking place June 11-14, 2025, by Frank Buttgereit, MD, Professor of Rheumatology and Deputy Head of the Department of Rheumatology and Clinical Immunology, Department of Rheumatology and Clinical Immunology, Charité-Universitätsmedizin Berlin.

Rates of serious infections through week 52 were numerically lower with both upadacitinib 15 mg (7.9 events/100 patient-years [E/100 PY]; 95% CI, 4.3–13.2) and 7.5 mg (7.9 E/100 PY; 95% CI, 3.2–16.3) compared to placebo (12.7 E/100 PY; 95% CI, 6.6–22.2). In contrast, herpes zoster rates were higher with upadacitinib 15 mg (7.3 E/100 PY; 95% CI, 3.9–12.5) but comparable between upadacitinib 7.5 mg (4.5 E/100 PY; 95% CI, 1.2–11.6) and placebo (4.2 E/100 PY; 95% CI, 1.2–10.9).

Opportunistic infections were rare across all groups. No cases were reported with the 7.5 mg dose, while four were seen with 15 mg, including one serious case of Pneumocystis jiroveci pneumonia that led to treatment discontinuation. The others were mild to moderate and did not result in discontinuation.

In the post-glucocorticoid (GC) taper period, serious infection rates remained lower with upadacitinib 7.5 mg (3.4 E/100 PY; 95% CI, 0.7–9.9) and 15 mg (3.9 E/100 PY; 95% CI, 1.6–8.1) compared to placebo (8.5 E/100 PY; 95% CI, 3.7–16.7). Herpes zoster rates during and after the GC taper were similar between upadacitinib 15 mg and placebo. Of the four opportunistic infections in the 15 mg group, three occurred during the taper and one after, in a patient on GC escape therapy. Baseline GC dose did not appear to influence serious infection risk.

spoke with Buttgereit to learn more about the SELECT-GCA trial, what it aimed to assess, and how its trial design compared the different treatment regimens and glucocorticoid tapering strategies.

Upadacitinib 15 mg once daily was previously approved for the treatment of adults with GCA, under the name Rinvoq, in April 2025.

Buttgereit F, Winthrop KL, Calabrese LH, et al. Impact of Glucocorticoid Tapering in Giant Cell Arteritis: Analysis From the SELECT-GCA Trial. Presented at: EULAR Congress 2025; Barcelona, Spain; June 11-14. Presentation #OP0057

RINVOQ® (upadacitinib) Receives U.S. FDA Approval for Giant Cell Arteritis (GCA). News release. AbbVie. April 29, 2025. https://news.abbvie.com/2025-04-29-RINVOQ-R-upadacitinib-Receives-U-S-FDA-Approval-for-Giant-Cell-Arteritis-GCA

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New findings highlight upadacitinib's effectiveness in treating giant cell arteritis, showcasing lower infection rates and improved glucocorticoid tapering strategies.

Frank Buttgereit, MD

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