Evaluating upadacitinib for the treatment of psoriatic arthritis. (22nd January 2022)

• Record Type: Journal Article
• Authors: Akpabio, Akpabio; Adebajo, Adewale
• Is Part Of: Expert opinion on pharmacotherapy. Volume 23:Number 2(2022)
• Page Start: 169
• Page End: 173
• Publication Date: 2022-01-22
• Subjects: Janus kinase inhibitor -- psoriatic arthritis -- upadacitinib -- review -- treatment; Chemotherapy -- Periodicals; 615.5805
• DOI: 10.1080/14656566.2021.2006183
• Languages: English
• ISSNs: 1465-6566

Abstract

ABSTRACT: Introduction: Psoriatic arthritis is an extra-cutaneous manifestation affecting up to 40% of psoriasis patients with multiple therapies recommended by international guidelines including conventional and targeted synthetic disease-modifying anti-rheumatic drugs (DMARDs) as well as biologics. Janus kinase inhibitors (JAKis) have emerged as a unique therapeutic target with tofacitinib the first to gain FDA approval in 2017. The non-selectivity of older JAKis increases the risk of off-target effects such as suppression of hemopoiesis hence the rationale for more selective alternatives. Areas covered: This paper explores the use of upadacitinib (a selective JAK1 inhibitor) for the treatment of psoriatic arthritis. It covers its chemical properties, pharmacokinetics, pharmacodynamics, efficacy, safety and regulation. Expert opinion: In our opinion, upadacitinib is set to play an important role in the treatment of psoriatic arthritis as demonstrated by the SELECT-PsA trials especially in patients with poor or non-response to current first-line therapies. It's JAK1 receptor selectivity promises a lower side effect profile compared to the older nonselective JAKis but this will require confirmation with long-term clinical trial data.