Upadacitinib, sold under the brand name Rinvoq, is a Janus kinase (JAK) inhibitor medication for the treatment of moderately to severely active rheumatoid arthritis and psoriatic arthritis in adults where methotrexate (a drug used to treat active arthritis) did not work well or could not be tolerated. It was approved for medical use in the United States and in the European Union in 2019, and was developed by the biotech company AbbVie. Common side effects include upper respiratory tract infections (common cold, sinus infections), nausea, cough, and fever.Upadacitinib works by blocking the action of enzymes called Janus kinases. These enzymes are involved in setting up processes that lead to inflammation, and blocking their effect brings inflammation in the joints under control. Medical uses
Upadacitinib is indicated for the treatment of moderate to severe active rheumatoid arthritis in adults who have responded inadequately to, or who are intolerant to one or more disease-modifying antirheumatic drugs (DMARDs). Upadacitinib may be used as monotherapy or in combination with methotrexate. Contraindications
The drug is contraindicated in people with active tuberculosis and other severe infections, severe liver impairment (Child–Pugh score C), and during pregnancy.The use of upadacitinib in combination with other Janus kinase inhibitors, biologic DMARDs, or with potent immunosuppressants such as azathioprine and ciclosporin is not recommended. Interactions
Substances that strongly inhibit the liver enzyme CYP3A4, such as ketoconazole, itraconazole or clarithromycin, increase upadacitinib concentrations in the body. In a study, ketoconazole increased its AUC by 75%. Conversely, substances that strongly induce CYP3A4 lower upadacitinib concentrations.
Acquired cystic kidney disease-associated renal cell carcinoma is rare subtype of renal cell carcinoma. It is most commonly seen in people with end-stage kidney disease who have a much higher risk of developing acquired cystic kidney disease (ACKD). Affected individuals have small kidneys with several cysts and their risk of renal cell carcinoma is 30 times higher than people without ACKD. Bloody urine and flank pain in a person with end-stage kidney disease raise suspicion for ACKD-associated renal cell carcinoma. Although people with ACKD have a substantially higher risk of renal cell carcinoma, routine screening is not recommended. ACKD-associated renal cell carcinoma is an uncommon cause of death for people with end-stage kidney disease. References


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