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Upadacitinib for the Treatment of Rheumatoid Arthritis: An Extensive Review
Eric G Boyce1, Edward L Rogan1, May C Lui1
1Department of Pharmacy Practice, Thomas J. Long School of Pharmacy, University of the Pacific, Stockton, CA, USA.
The Annals of Pharmacotherapy
|August 3, 2022
Summary
Upadacitinib effectively treats rheumatoid arthritis (RA) by improving symptoms in patients. This Janus kinase (JAK) inhibitor offers a new option for those with moderate to severe RA.
Area of Science:
- Rheumatology
- Immunology
- Pharmacology
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease.
- Janus kinase (JAK) inhibitors represent a class of targeted therapies for RA.
- Upadacitinib is an oral JAK inhibitor developed for RA treatment.
Purpose of the Study:
- To review the characteristics, efficacy, safety, pharmacoeconomics, and therapeutic role of upadacitinib in RA.
- To assess upadacitinib's performance against conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) and other biologic DMARDs (bDMARDs).
Main Methods:
- Systematic literature search of PubMed (2003-2022) for upadacitinib and ABT-494.
- Inclusion of human studies published in English peer-reviewed journals.
- Analysis of randomized, double-blind, controlled clinical trials for efficacy and safety data.
Main Results:
- Upadacitinib demonstrated statistically significant improvements in RA symptoms compared to csDMARD monotherapy and in combination with csDMARDs versus other treatments.
- Response rates (ACR20) for upadacitinib ranged from 64% to 84%, compared to 28% to 74% for control groups.
- Safety profiles showed similar rates of serious infections, herpes zoster, MACE, and VTE events as other JAK inhibitors.
Conclusions:
- Upadacitinib is an effective JAK inhibitor for RA treatment.
- It serves as an alternative therapy for patients with moderate to severe RA refractory to TNF inhibitors.
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