Rinvoq (upadacitinib) is an oral, once-daily Janus kinase (JAK) inhibitor. In dermatology, it is indicated for the treatment of adults and pediatric patients 12 years and older with moderate to severe atopic dermatitis that is not adequately controlled with other systemic drugs and the treatment of adults and pediatric patients 2 years and older with active psoriatic arthritis who have had an inadequate response or intolerance to one or more TNF blockers.
It is also indicated for the treatment of rheumatoid arthritis, ulcerative colitis, Crohn’s disease, active ankylosing spondylitis, active nonradiographic axial spondyloarthritis, and active polyarticular juvenile idiopathic arthritis.
Rinvoq works by selectively inhibiting JAK1, with greater potency than JAK2, JAK3 and TYK2. By targeting the JAK-STAT signaling pathway, Rinvoq blocks the recruitment, phosphorylation, and activation of STATs, preventing pro-inflammatory cytokine signaling and inhibiting pro-inflammatory processes.
For atopic dermatitis, the package insert specifically mentions the following adverse reactions (≥ 1%): upper respiratory tract infections, acne, herpes simplex, headache, blood creatine phosphokinase increase, cough, hypersensitivity, folliculitis, nausea, abdominal pain, pyrexia, increased weight, herpes zoster, influenza, fatigue, neutropenia, myalgia, and influenza-like illness.
For psoriatic arthritis, it mentions the following adverse reactions (≥ 1%): upper respiratory tract infections, herpes zoster, herpes simplex, bronchitis, nausea, cough, pyrexia, acne, and headache.
Rinvoq is not recommended for use in combination with other JAK inhibitors, biologic immunomodulators, or other immunosuppressants.
Rinvoq offers a targeted oral option for patients with moderate-to-severe atopic dermatitis or active psoriatic arthritis who have not achieved adequate control with existing therapies. It can be integrated into treatment plans as a standalone systemic therapy. By addressing the JAK-STAT pathway, Rinvoq helps reduce inflammation and improve disease control, offering an effective option for patients living with refractory disease.