Upadacitinib (Rinvoq)

Who is it for?

Rinvoq is a prescription medicine used to treat adults and children 12 years of age and older with moderate to severe eczema (atopic dermatitis) that has not responded to previous treatment and where their eczema is not well controlled with other pills or injections, including biologic medicines, or the use of other pills or injections is not recommended. Rinvoq is safe and effective in children 12 years of age and older weighing at least 40 kg with atopic dermatitis.

Rinvoq is not a steroid, topical or injection. It’s a once-daily pill to help treat your eczema symptoms to deliver relief.

How does it work?

With eczema, an overactive immune system may cause excess inflammation, contributing to symptoms like itch and rash. Rinvoq works inside the body to help regulate your overactive immune system. It does this by blocking certain signals that are thought to contribute to excess inflammation.

Rinvoq is an oral Janus Kinase (JAK) inhibitor medication for the treatment of refractory, moderate to severe atopic dermatitis and is available by prescription only.

The inflammation of AD is caused in part by immune system messengers called cytokines that are increased in the blood and the skin. Several of these inflammatory cytokines exert their effects through a chemical signal pathway inside cells known as the JAK-STAT pathway (Janus Kinase-Signal transducer and activators of transcription).

The JAK family has four members – JAK inhibitors can target one or more of these family members to block these immune signals and inhibit the inflammatory effect of key cytokines involved in AD. Rinvoq works by selectively blocking JAK1 resulting in improvement in AD signs and symptoms.

What has the research shown?

Clinical trials of Rinvoq have shown that it produces a meaningful reduction in the severity of eczema, as well as a reduction in the body surface affected by eczema in the majority of patients. Many patients receiving dupliumab also experience a reduction in itching and an improvement in sleep and quality of life. The trial data results showed that many patients taking Rinvoq no longer needed to apply as much topical steroid while taking the drug.

Is it available?

Rinvoq is available in Australia and was listed on the PBS in February 2022 and is approved to treat adults and children 12 years of age and older with moderate to severe eczema (atopic dermatitis).

How do I go about getting it?

If you think you might be eligible for Rinvoq, speak to your specialist about the possibility of trying it. It will not be offered by GP; you will need to be referred to a dermatologist or immunologist.

How is it administered?

• Take Rinvoq as prescribed: one pill, once a day, every day
• Take Rinvoq with or without food
• Do not split, crush, or chew the pill
• Available in 15 mg or 30 mg extended-release tablets
• Follow dosing instructions as prescribed

How long do you take it for?

Rinvoq is an ongoing treatment.

The specialists will monitor your treatment so you must do the following:

• keep all your appointments so your progress can be checked.
• keep your appointments for blood tests to make sure the medicine is working and as some side effects are seen in blood results before you have any symptoms.
• get regular skin checks, and wear sunscreen and a hat when outdoors.
• remind any doctor, pharmacist or dentist you visit that you are taking Rinvoq.
• call your doctor straight away if you become pregnant while taking Rinvoq.

Can people taking Rinvoq still use topical steroids and emollients?

Yes, patients taking Rinvoq will be expected to use topical steroids and moisturisers to manage their eczema alongside Rinvoq.

What are the risk of Rinvoq?

Some common side effects include acne, upper respiratory tract infections, nose or throat infections, nausea, high liver enzyme, blood creatine (creatinine is a chemical compound left over from energy-producing processes in your muscles), phosphokinase or cholesterol level increases, decreased neutrophil counts, headache, cough, fever, stomach discomfort, and weight gain.

Can children take Rinvoq?

Rinvoq is not currently available for children under 12 outside of a clinical trial.

Australians with severe dermatitis to benefit from PBS listing