Continuing upadacitinib beats withdrawal for giant cell arteritis remission

This blinded re-randomization extension of SELECT-GCA gives rheumatology pharmacists direct evidence that most patients who reach sustained remission at 1 year flare quickly if upadacitinib is stopped.

📅 Journal publication: Jul 28, 2026 · Last updated: Oct 7, 2026

upadacitinibJAK inhibitorJanus kinase inhibitorgiant cell arteritisvasculitisglucocorticoid-sparingSELECT-GCAremission maintenancetocilizumabrandomized withdrawalphase 3 extension Rheumatology / Immunology

Background Information

Upadacitinib maintains better remission in long-term GCA treatment.

Giant cell arteritis (GCA) often requires long-term treatment with glucocorticoids, which have significant side effects. This study examines the potential for upadacitinib to maintain remission while reducing glucocorticoid use. Patients continuing upadacitinib had fewer flares (7.4% vs 59.5%) and better glucocorticoid-free remission (71.7% vs 31.4%) compared to those switched to placebo over two years. Continued treatment with upadacitinib may allow patients with GCA to achieve better long-term outcomes with fewer glucocorticoid-related side effects. The study involves adults and is less directly relevant to pediatrics. Upadacitinib continuation improves remission and reduces glucocorticoid exposure in GCA patients over two years.

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Authors: Schmidt WA, Setty AR, Dejaco C, Rubbert-Roth A, Cid MC, Ishii T, Christ L, Joshi AD, Zerad N, Kadakia A, Zhao S, Zhao W, Lagunes I, Phillips C, Blockmans D, Merkel PA, SELECT-GCA study group

Citation: Schmidt WA, Setty AR, Dejaco C, et al. Clinical outcomes of upadacitinib continuation vs withdrawal in giant cell arteritis through 2 years. Annals of the rheumatic diseases. 2026. doi:10.1016/j.ard.2026.06.029

Article Links: PubMed · Journal / DOI

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