Efficacy Of Upadacitinib In Psoriatic Arthritis And Comparison To Rheumatoid Arthritis.

The inclusion criteria for Psoriatic Arthritis patients are:

1. Patients diagnosed with peripheral Psoriatic Arthritis according to the CASPARcriteria or with axial Psoriatic Arthritis according to ASAS criteria and with atleast one of the following:

2. With active peripheral Psoriatic Arthritis regarding ongoing therapy in one ofthe following sites: MCP joints 1-5, proximal interphalangeal (PIP) joints ofhands 1-5, distal interphalangeal (DIP) joints of hands 2-5, wrists, elbows,knees and ankles/heels and feet, according to any of the following criteria:I) DAPSA ≥ 15 and joint inflammation according to the Global OMERACT-EULAR USscoring for synovitis and power Doppler (GLOESS) with a grade at patient level >3,2II) With a clinical enthesitis and an active enthesitis (positive power Dopplerof any grade), in the clinical symptomatic site, according to the OMERACT USdefinitionsIII) With active dactylitis (clinical diagnosis made by the physician at thetime of baseline visit) and a positive US dactylitis according to theDACTylitis glObal Sonographic (DACTOS) score >3IV) DAPSA ≥ 15 and tenosynovitis according to the OMERACT US scoring system fortenosynovitis with a grade >1

3. With active axial PsA regarding ongoing therapy (ASDAS ≥ 2.1) and activesacroiliitis according to the ASAS MRI definitions

4. Who are eligible according to the current guidelines/regulations to start treatmentwith UPA and present a favorable risk/benefit profile according to the clinician'sopinion for such treatment.

5. Aged older than 18 years.

6. Able to provide informed consent, according to requirements of local IRB/ethicscommittee.

The inclusion criteria for Rheumatoid Arthritis patients are:

1. Patients diagnosed with RA according to the ACR/EULAR 2010 classification criteria

2. With active Rheumatoid Arthritis according to the following criteria: DAS28-PCR >3.2, and the presence of at least one US finding of the following:

3. Joint inflammation at hands and wrists according to the Global OMERACT-EULAR (GLOESS) US scoring for synovitis and power Doppler with a grade at patientlevel >2

4. One tenosynovitis at hands or wrists, according to the OMERACT US scoringsystem for tenosynovitis with a grade >1

5. Who are eligible according to the current guidelines/regulations to start treatmentwith Upadacitinib and present a favourable risk/benefit profile according to theclinician's opinion for such treatment.

6. Aged older than 18 years.

7. Able to provide informed consent, according to requirements of local IRB/ethicscommittee.

Exclusion Criteria:

1. Patients with any contraindication to Upadacitinib:

2. women who are pregnant or breastfeeding

3. active infection

4. evidence of tuberculosis infection

5. known infection with human immunodeficiency virus or hepatitis B or C

6. patients who have current malignancy or history of malignancy in the last 5years

7. high cardiovascular risk

8. high risk of venous thromboembolism

9. patients with severe hepatic impairment

10. Patients with associated fibromyalgia syndrome according to the 2016 ACR diagnosticcriteria

11. Unable to provide informed consent, according to requirements of local IRB/ethicscommittee.