Ryan DeMasi, MD: Direct and Indirect Impact of Pain in Rheumatoid Arthritis


Ryan DeMasi, MD, explained the direct and indirect effects of upadacitinib and adalimumab on pain in patients with rheumatoid arthritis.

In an interview with HCPLive, Ryan DeMasi, MD, therapeutic area head of medical affairs, rheumatology, at AbbVie, discussed his study “Direct and Indirect Effects of Upadacitinib or Adalimumab on Pain in Rheumatoid Arthritis: Results from a Randomized Phase 3 Study,” presented at the American College of Rheumatology’s 2023 Convergence in San Diego, California.1

DeMasi emphasized pain is a pivotal factor for patients, which in turn influences their decision to seek or modify care. The phase 3 study, SELECT-COMPARE, revealed significantly greater pain improvement with upadacitinib (Rinvoq) compared with adalimumab (Humira) in patients with rheumatoid arthritis (RA). He explained understanding this improvement in pain is critical, considering even when patients had clinically-relevant laboratory results, such as joint improvement, some may not feel better, shedding light on the complexity of pain. His study focused on the direct impact of pain itself, which is particularly vital for this patient population, as managing longer-standing diseases sometimes does not guarantee an overall sense of wellbeing.

He stated there is often a disconnect between the pain patients feel and what they convey to doctors. Understanding the drivers of pain and refining treatment approaches is essential for long-term patient wellbeing. In SELECT-COMPARE, upadacitinib demonstrated a notably superior pain improvement at week 12, especially in addressing noninflammatory pain components. This has profound implications for patients dealing with substantial pain and seeking effective therapeutic options.

Further, addressing the importance of patient-reported outcomes is crucial. Traditional rheumatology treatments often focus on measurable clinical parameters like joint counts or blood tests, creating a gap between physician observations and patient experiences. Patients may express concerns or goals not reflected in standard measures, emphasizing the need for patient-reported outcomes. These patient-reported outcomes bridge the divide to better understand what truly matters to patients, aligning their version of therapy success with clinical objectives. Without this connection, holistic patient care remains elusive.


  1. Taylor P, Walsh D, Takeuchi T, Fautrel B, et al. Direct and Indirect Effects of Upadacitinib or Adalimumab on Pain in Rheumatoid Arthritis: Results from a Randomized Phase 3 Study. Presented at: American College of Rheumatology Convergence 2023. San Diego, CA. November 10-15, 2023.
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