McInnes IB, Anderson JK, Magrey M, et al. - Among patients suffering from psoriatic arthritis with an inadequate response to nonbiologic disease-modifying antirheumatic drugs, researchers undertook this 24-week, phase 3 trial to clarify the efficacy as well as the safety of upadacitinib (Janus kinase inhibitor) vs adalimumab (a tumor necrosis factor α inhibitor). They randomized patients 1:1:1:1 to receive oral upadacitinib at a dose of 15 mg or 30 mg once daily, placebo, or subcutaneous adalimumab (40 mg every other week). Overall 1,704 patients were administered an active drug or placebo. Findings revealed that 15 mg or 30 mg upadacitinib resulted in a significantly higher percentage of patients with psoriatic arthritis who exhibited an ACR20 (American College of Rheumatology 20: ≥ 20% reduction in the number of tender and swollen joints and ≥ 20% improvement in at least three of five other domains) response at week 12 when compared with placebo. Results demonstrated the superiority of 30 mg dose, but not of the 15 mg dose, over adalimumab. Upadacitinib was associated with more frequent adverse events than placebo.