upadacitinib (Rinvoq, ABT-494)
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Indications
- treatment of rheumatoid arthritis[4] (FDA-approved)
- 74% improvement in patients with severe atopic dermatitis[2]
- superior to dupilumab (Dupixent) for moderate-severe atopic dermatitis[7]
Dosage
Adverse effects
- venous thromboembolism
- neutropenia[3]
- infections
- drug adverse effects of tyrosine kinase inhibitor(s)
- drug adverse effects of janus kinase inhibitors
Mechanism of action
- inhibits JAK-1
Clinical trials
- clinical response at week 12 was significantly higher with 15 or 30 mg of upadacitinib than with placebo[6]
- 30 mg dose but not the 15 mg dose was superior to adalimumab[6]
- adverse events were more frequent with upadacitinib than with placebo[6]
More general terms
References
- ↑ McNamara D JAK-1 Inhibitor Effective for RA, but Safety Signal Troubles. Medscape - Nov 13, 2017. https://www.medscape.com/viewarticle/888522
- ↑ 2.0 2.1 Bankhead C Strong Eczema Response to JAK Inhibitor. Half of patients achieved EASI 90 at 16 weeks. MedPage Today. February 19, 2018 https://www.medpagetoday.com/meetingcoverage/aad/71244
Guttman-Yassky E, et al Primary results from a phase IIb, randomized, placebo controlled trial of upadacitinib for patients with atopic dermatitis. American Academy of Dermatology (AAD) 2018; Abstract 6533. - ↑ 3.0 3.1 Walsh N, Promising Results Seen with New JAK-1 Drug. Upadacitinib showed significant efficacy in DMARD inadequate responders. MedPage Today. May 03, 2018 https://www.medpagetoday.com/meetingcoverage/bsr/72680
Burmester G, et al A phase III randomized placebo-controlled double-blind study of upadacitinib (ABT-494), a selective JAK-1 inhibitor, in patients with active rheumatoid arthritis with inadequate response to conventional synthetic DMARDs. British Society for Rheumatology (BSR) 2018; abstract 242 - ↑ 4.0 4.1 Walsh N New JAK1 Agent Beats Humira in Rheumatoid Arthritis Thrombotic events balanced between upadacitinib, adalimumab, and placebo. MedPage Today. October 22, 2018 https://www.medpagetoday.com/meetingcoverage/acr/75846
Fleischmann R, Pangan AL, Mysler E et al A Phase 3, Randomized, Double-Blind Study Comparing Upadacitinib to Placebo and to Adalimumab, in Patients with Active Rheumatoid Arthritis with Inadequate Response to Methotrexate. American College of Rheumatology (ACR) 2018 annual meeting. Abstract 890. https://acrabstracts.org/abstract/a-phase-3-randomized-double-blind-study-comparing-upadacitinib-to-placebo-and-to-adalimumab-in-patients-with-active-rheumatoid-arthritis-with-inadequate-response-to-methotrexate/ - ↑ Walsh N Rinvoq for RA: Benefits Persist Beyond 1 Year - Manufacturer's extension study shows no loss of clinical response. MedPage Today November 6, 2020 https://www.medpagetoday.com/meetingcoverage/acr/89523
van Vollenhoven R, et al Upadacitinib monotherapy in methotrexate-naive patients with rheumatoid arthritis: results at 72 weeks. American College of Rheumatology (ACR) 2020; Abstract 0207 - ↑ 6.0 6.1 6.2 6.3 McInnes IB, Anderson JK, Magrey M et al Trial of Upadacitinib and Adalimumab for Psoriatic Arthritis. N Engl J Med 2021; 384:1227-1239. April 1. PMID: https://www.ncbi.nlm.nih.gov/pubmed/33789011 https://www.nejm.org/doi/full/10.1056/NEJMoa2022516
- ↑ 7.0 7.1 Gever J JAK Inhibitor Tops Mab for Eczema. New disease-modifying treatment option on the horizon. MedPage Today August 4, 2021 https://www.medpagetoday.com/dermatology/atopy/93891
Blauvelt A, Teixeira HD, Simpson EL et al Efficacy and Safety of Upadacitinib vs Dupilumab in Adults With Moderate-to-Severe Atopic DermatitisA Randomized Clinical Trial. JAMA Dermatol. 2021 Aug 4 PMID: https://www.ncbi.nlm.nih.gov/pubmed/34347860 https://jamanetwork.com/journals/jamadermatology/fullarticle/2782803