Upadacitinib

Upadacitinib is an oral selective inhibitor of the enzyme Janus kinase 1 (JAK1) developed by AbbVie and marketed under the brand Rinvoq. By targeting JAK1, it reduces signaling of several pro-inflammatory cytokines involved in autoimmune and inflammatory diseases, thereby dampening immune responses.

Approved uses include adults with moderate to severe rheumatoid arthritis, psoriatic arthritis, and axial spondyloarthritis, as well as adults with moderate-to-severe atopic dermatitis in certain treatment contexts. The exact indications and eligible patient populations are defined in regional product labeling and may evolve with new approvals.

Administration and dosing: Upadacitinib is taken as a once-daily oral tablet. Dosing is determined by the specific indication, prior therapies, and patient safety considerations, with adjustments made for tolerability and response. Typical dosing guidelines vary by condition and regulatory region.

Safety and contraindications: Upadacitinib carries boxed warnings for serious infections, malignancies, major adverse cardiovascular events, and thrombosis. Other potential adverse effects include cytopenias, lipid elevations, and elevations in liver enzymes. It should be used with caution in patients with active infections, a history of malignancy, cardiovascular risk factors, thrombotic risk, liver disease, or lipid abnormalities. Patients are generally screened for latent tuberculosis before initiating therapy and monitored for infections and laboratory abnormalities during treatment. As with other JAK inhibitors, monitoring and risk-benefit assessment are important components of therapy.