Upadacitinib (Rinvoq)

What is Upadacitinib?

Upadacitinib (Rinvoq) is an oral Janus kinase (JAK) inhibitor. In dermatology-related care, it is approved for adults and adolescents 12 years of age and older who weigh at least 40 kg and have moderate-to-severe atopic dermatitis whose disease is not adequately controlled with other systemic treatments, including biologics, or when those treatments are not advisable. It is also approved for active psoriatic arthritis in adults who have had an inadequate response or intolerance to one or more TNF blockers.

How does Upadacitinib work?

Upadacitinib works by blocking JAK signaling inside cells, which helps reduce inflammatory signaling involved in immune-mediated disease. Like other medications in the JAK inhibitor class, it blocks certain signals thought to drive inflammation.

What are possible side effects of Upadacitinib?

Common side effects include upper respiratory infections, acne, nausea, cough, headache, and herpes infections such as cold sores or shingles. More serious side effects can include serious infections, blood clots, cardiovascular events, certain cancers, gastrointestinal perforation, and abnormal lab results. Your provider may monitor bloodwork and other safety markers during treatment.

How is Upadacitinib used?

Upadacitinib is taken by mouth once daily as an extended-release tablet. For atopic dermatitis, in people 12 years of age and older, it is typically dosed once daily.

Before starting upadacitinib, providers generally review for active or latent tuberculosis, screen for viral hepatitis, assess hepatic function, verify pregnancy status when relevant, and update immunizations. Live vaccines are avoided during treatment, grapefruit should be avoided, and for atopic dermatitis the medication is not recommended in combination with other JAK inhibitors, biologic immunomodulators, or other immunosuppressants.