Upadacitinib is an oral JAK1 inhibitor being developed for patients with severe atopic dermatitis. Multiple phase 2 randomized placebo controlled studies have examined the efficacy of upadacitinib in adults and adolescent patients with moderate to severe atopic dermatitis.
Published in The Lancet, 2 replicate 16-week trials showed that monotherapy with upadacitinib improved symptom and disease severity compared to placebo. They also found that the combination of upadacitinib and topical steroids, was better than placebo and topical steroids alone.
Upadacitinib was well tolerated in all trials as well.
We have discussed the oral JAK1 inhibitors in the past with the blog post, Abrocitinib for Atopic Dermatitis by Pfizer
This likely will be the first oral drug on the market approved for atopic dermatitis. There are a host of other medications being studied right now for eczema. New treatments for eczema on the horizon
Eczema or atopic dermatitis for many years has been treated with topical medications only. Topical corticosteroids are the mainstays of treatment, but later drugs that were developed have been Elidel, Protopic and Eucrisa.
Since then the first biological medication was approved, Dupixent. This was the first drug to treat eczema from “within” and not just topically. Researchers have come to realize that atopic dermatitis is not just a disease that is topically related, but from an internal systemic inflammation. So many of the new products being developed are treating eczema systemically.
Upadacitinib is already FDA for the treatment of moderate to severely active rheumatoid arthritis. It was approved in the United States and Europe in 2019. It is sold under the name, Rinvoq. It is also being investigated for rheumatoid arthritis, Crohn’s disease, ulcerative colitis, atopic dermatitis, psoriatic arthritis, axial SpA Giant Cell Arteritis and Takayasu Arteritis.
The drug manufacturer is AbbVie. Common side effects include upper respiratory tract infections (common cold, sinus infections), nausea, cough, and fever.
Upadacitinib likely won’t be first in line for eczema as part of the JAK1 inhibitor family, and there will likely many in this category in the future.
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