2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T462,The treatment of anti-melanoma differentiation-associated gene 5 antibody-positive dermatomyositis with interstitial lung disease (MDA5 This multi-centre cohort study in China enrolled MDA5 In the eligible cohort, a total of 106 patients were treated with UPA and 328 with TOFA. The crude 6-month lung transplantation-free survival rates were 71.7% (76/106) in the UPA group and 67.4% (221/328) in the TOFA group. In the IPTW-adjusted cohort, UPA showed a trend toward higher survival than TOFA (p = 0.067), with a weighted risk difference of 10.3% (95% confidence interval -0.4% to 20.2%) meeting the non-inferiority margin (non-inferiority p = 0.003). Sensitivity and subgroup analyses showed consistent results, with potentially greater benefit of UPA in incident JAK inhibitor users (as first-line treatment), monotherapy recipients (without combination with other immunosuppressants except steroid), and those with rapidly progressive ILD. Safety profiles were comparable between groups. UPA was found to be non-inferior to TOFA in improving 6-month lung transplantation-free survival among patients with MDA531:Tb4a,ABSTRACT Background and Objective The treatment of anti‐melanoma differentiation‐associated gene 5 antibody‐positive dermatomyositis with interstitial lung disease (MDA5 + DM‐ILD) remains a significant clinical challenge. To compare the effectiveness and safety of upadacitinib (UPA) versus tofacitinib (TOFA) upon 6‐month lung transplantation‐free survival in newly diagnosed MDA5 + DM‐ILD patients. Methods This multi‐centre cohort study in China enrolled MDA5 + DM‐ILD patients treated from January 2020 to February 2025. Prevalent/incident new users and non‐inferior design along with inverse probability treatment weighting (IPTW) were implemented to emulate randomized controlled trial. Results In the eligible cohort, a total of 106 patients were treated with UPA and 328 with TOFA. The crude 6‐month lung transplantation‐free survival rates were 71.7% (76/106) in the UPA group and 67.4% (221/328) in the TOFA group. In the IPTW‐adjusted cohort, UPA showed a trend toward higher survival than TOFA ( p = 0.067), with a weighted risk difference of 10.3% (95% confidence interval −0.4% to 20.2%) meeting the non‐inferiority margin (non‐inferiority p = 0.003). Sensitivity and subgroup analyses showed consistent results, with potentially greater benefit of UPA in incident JAK inhibitor users (as first‐line treatment), monotherapy recipients (without combination with other immunosuppressants except steroid), and those with rapidly progressive ILD. Safety profiles were comparable between groups. Conclusion UPA was found to be non‐inferior to TOFA in improving 6‐month lung transplantation‐free survival among patients with MDA5 + DM‐ILD, with comparable safety. 25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Anti-MDA5 Antibody-Positive Dermatomyositis: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Anti-MDA5 Antibody-Positive Dermatomyositis (condition). Clinician-written summaries and actionable practice insights. 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The crude 6-month lung transplantation-free survival rates were 71.7% (76/106) in the UPA group and 67.4% (221/328) in the TOFA group. In the IPTW-adjusted cohort, UPA showed a trend toward higher survival than TOFA (p = 0.067), with a weighted risk difference of 10.3% (95% confidence interval -0.4% to 20.2%) meeting the non-inferiority margin (non-inferiority p = 0.003). Sensitivity and subgroup analyses showed consistent results, with potentially greater benefit of UPA in incident JAK inhibitor users (as first-line treatment), monotherapy recipients (without combination with other immunosuppressants except steroid), and those with rapidly progressive ILD. Safety profiles were comparable between groups.","abstract":"$30","keywords":["MDA5","dermatomyositis","interstitial lung disease","tofacitinib","upadacitinib"],"pubmed_id":"41983711","conclusions":"UPA was found to be non-inferior to TOFA in improving 6-month lung transplantation-free survival among patients with 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Total sample size of 434 is derived from 106 (UPA) + 328 (TOFA) as reported.","value_numeric":null},{"paper_doi":"10.1002/resp.70248","tag_type":"warning","value":"The 'practice_changing' impact flag is applied cautiously—this is an observational cohort study with IPTW, not a true RCT; results should be interpreted as hypothesis-generating pending prospective confirmation.","value_numeric":null}],"summaries":{"what_studied":"This multi-centre cohort study from China compared upadacitinib (UPA) vs. tofacitinib (TOFA) for 6-month lung transplantation-free survival in newly diagnosed anti-MDA5-positive dermatomyositis with interstitial lung disease (MDA5+DM-ILD), enrolling patients treated January 2020–February 2025 and using inverse probability treatment weighting (IPTW) to emulate a randomized trial.","key_result":"UPA was non-inferior to TOFA (non-inferiority p = 0.003); crude 6-month lung transplantation-free survival was 71.7% (76/106) with UPA vs. 67.4% (221/328) with TOFA; IPTW-adjusted weighted risk difference was +10.3% (95% CI −0.4% to 20.2%) favoring UPA, though the superiority trend did not reach significance (p = 0.067). Subgroup analyses suggested potentially greater UPA benefit in first-line JAK inhibitor users, monotherapy recipients, and rapidly progressive ILD.","limitations":"Observational design with IPTW emulation cannot fully replace a true RCT; unmeasured confounding (e.g., disease severity nuances, physician preference) may persist. Study was conducted entirely in China, limiting generalizability to other populations. The 6-month endpoint may miss longer-term divergence in outcomes or late adverse effects.","practice_takeaway":"For patients with MDA5+DM-ILD, upadacitinib appears at least as effective as tofacitinib at 6 months, with a comparable safety profile—making it a reasonable alternative, particularly as first-line JAK inhibitor therapy or in rapidly progressive ILD. Clinicians should note this is observational evidence; prospective RCT confirmation is still needed."}}],"initialOffset":1,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Anti-MDA5 Antibody-Positive Dermatomyositis"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Anti-MDA5 Antibody-Positive Dermatomyositis"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Anti-MDA5 Antibody-Positive Dermatomyositis"}}}]]

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