Off-Label Uses of Upadacitinib
Main Article Content
Keywords
JAK inhibitor, off-label, dermatology, upadacitinib
Abstract
Background: Janus Kinase (JAK) inhibitors interfere with the JAK-STAT signaling pathway, which is vital in regulating inflammation and immune function. Notably, upadacitinib, a JAK inhibitor, has been increasingly used as a treatment modality for refractory inflammatory diseases.
Methods: A literature review was conducted on Pubmed and Clinical Trials.gov using the keywords “upadacitinib” combined with “off-label”, “dermatology”, “skin”, or “cutaneous” from October 1st, 2021, to October 1st, 2023. 941 articles were reviewed, and 50 articles were included.
Results: The systematic search revealed 20 different dermatology conditions treated with off-label use of upadacitinib. Most of these conditions showed drastic improvement by actively decreasing the inflammatory response involved in the pathogenesis of that condition. The most common side effects reported for the medication were elevated creatine kinase, headaches, urinary tract infections, and acne. Patients should also be advised to consider the shingles vaccines prior to upadacitinib treatment.
Conclusion: Upadacitinib shows potential utility in the treatment of refractory inflammatory dermatologic conditions, treatment-resistant pruritus, and medication-induced skin reactions. Further large-scale, controlled clinical trials are needed to evaluate the further indications of upadacitinib and its safety profile.
References
1. Spinelli FR, Meylan F, O’Shea JJ, Gadina M. JAK inhibitors: Ten years after. Eur J Immunol. 2021;51(7):1615-1627. doi:10.1002/eji.202048922
2. Tofacitinib - an overview | ScienceDirect Topics. Accessed February 24, 2024. https://www.sciencedirect.com/topics/chemistry/tofacitinib#
3. Damsky W, King BA. JAK inhibitors in dermatology: The promise of a new drug class. J Am Acad Dermatol. 2017;76(4):736-744. doi:10.1016/j.jaad.2016.12.005
4. Ciechanowicz P, Rakowska A, Sikora M, Rudnicka L. JAK-inhibitors in dermatology: current evidence and future applications. J Dermatolog Treat. 2019;30(7):648-658. doi:10.1080/09546634.2018.1546043
5. Yu V, Pistillo J, Archibeque I, et al. Differential selectivity of JAK2 inhibitors in enzymatic and cellular settings. Experimental Hematology. 2013;41(5):491-500. doi:10.1016/j.exphem.2013.01.005
6. U.S. FDA Approves RINVOQ® (upadacitinib) as a Once-Daily Pill for Moderately to Severely Active Crohn’s Disease in Adults. AbbVie News Center. Accessed February 24, 2024. https://news.abbvie.com/2023-05-18-U-S-FDA-Approves-RINVOQ-R-upadacitinib-as-a-Once-Daily-Pill-for-Moderately-to-Severely-Active-Crohns-Disease-in-Adults
7. Blair HA. Ritlecitinib: First Approval. Drugs. 2023;83(14):1315-1321. doi:10.1007/s40265-023-01928-y
8. Freitas E, Guttman-Yassky E, Torres T. Baricitinib for the Treatment of Alopecia Areata. Drugs. 2023;83(9):761-770. doi:10.1007/s40265-023-01873-w
9. Johnston LA, Poelman SM. Upadacitinib for management of recalcitrant alopecia areata: A retrospective case series. JAAD Case Rep. 2023;35:38-42. doi:10.1016/j.jdcr.2023.02.019
10. Cantelli M, Martora F, Patruno C, Nappa P, Fabbrocini G, Napolitano M. Upadacitinib improved alopecia areata in a patient with atopic dermatitis: A case report. Dermatol Ther. 2022;35(4):e15346. doi:10.1111/dth.15346
11. Asfour L, Getsos Colla T, Moussa A, Sinclair RD. Concurrent chronic alopecia areata and severe atopic dermatitis successfully treated with upadacitinib. International Journal of Dermatology. 2022;61(11):e416-e417. doi:10.1111/ijd.16316
12. Walls B, Reguiai Z. Dual efficacy of upadacitinib in a patient with concomitant severe atopic dermatitis and alopecia areata. Annales de Dermatologie et de Vénéréologie. Published online June 27, 2023. doi:10.1016/j.annder.2023.03.010
13. Bourkas AN, Sibbald C. Upadacitinib for the treatment of alopecia areata and severe atopic dermatitis in a paediatric patient: A case report. SAGE Open Med Case Rep. 2022;10:2050313X221138452. doi:10.1177/2050313X221138452
14. Novielli D, Foti C, Principi M, et al. Upadacitinib in concurrent Crohn’s disease, atopic dermatitis and alopecia areata: A case report. Journal of the European Academy of Dermatology and Venereology. n/a(n/a). doi:10.1111/jdv.19377
15. Gori N, Cappilli S, Di Stefani A, Tassone F, Chiricozzi A, Peris K. Assessment of alopecia areata universalis successfully treated with upadacitinib. Int J Dermatol. 2023;62(2):e61-e63. doi:10.1111/ijd.16342
16. Youssef S, Bordone LA. Effective treatment of alopecia universalis with oral upadacitinib. JAAD Case Rep. 2022;31:80-82. doi:10.1016/j.jdcr.2022.08.014
17. YU D, REN Y. Upadacitinib for Successful Treatment of Alopecia Universalis in a Child: A Case Report and Literature Review. Acta Derm Venereol. 2023;103:5578. doi:10.2340/actadv.v103.5578
18. Johnston LA, Lu C, Poelman SM. Successful treatment of concomitant alopecia universalis and Crohn’s disease with upadacitinib: A case report. SAGE Open Med Case Rep. 2023;11:2050313X231160914. doi:10.1177/2050313X231160914
19. Kołcz K, Żychowska M, Sawińska E, Reich A. Alopecia Universalis in an Adolescent Successfully Treated with Upadacitinib-A Case Report and Review of the Literature on the Use of JAK Inhibitors in Pediatric Alopecia Areata. Dermatol Ther (Heidelb). 2023;13(3):843-856. doi:10.1007/s13555-023-00889-0
20. Flora A, Kozera E, Frew JW. Treatment of alopecia areata with the janus kinase inhibitor upadacitinib: A retrospective cohort study. Journal of the American Academy of Dermatology. 2023;89(1):137-138. doi:10.1016/j.jaad.2022.12.056
21. Johnston LA, Poelman SM. Upadacitinib for management of recalcitrant alopecia areata: A retrospective case series. JAAD Case Rep. 2023;35:38-42. doi:10.1016/j.jdcr.2023.02.019
22. Study Details | A Study to Evaluate the Safety and Effectiveness of Upadacitinib Tablets in Adult and Adolescent Participants With Severe Alopecia Areata | ClinicalTrials.gov. Accessed November 12, 2023. https://clinicaltrials.gov/study/NCT06012240?cond=Alopecia%20Areata&intr=upadacitinib&rank=1
23. Mease PJ, Lertratanakul A, Papp KA, et al. Upadacitinib in Patients with Psoriatic Arthritis and Inadequate Response to Biologics: 56-Week Data from the Randomized Controlled Phase 3 SELECT-PsA 2 Study. Rheumatol Ther. 2021;8(2):903-919. doi:10.1007/s40744-021-00305-z
24. Gargiulo L, Ibba L, Pavia G, et al. Upadacitinib for the treatment of concomitant psoriasis and atopic dermatitis: a case series. Journal of Dermatological Treatment. 2023;34(1):2183729. doi:10.1080/09546634.2023.2183729
25. Martinez-Molina M, Lluch-Galcerá JJ, Carrascosa JM. Response to upadacitinib in a patient with palmoplantar psoriasis. Eur J Dermatol. 2023;33(3):301-302. doi:10.1684/ejd.2023.4489
26. Wang N, Yang Q, Liu Y, Liu H. Upadacitinib in nail psoriasis: a case report. J Dermatolog Treat. 2023;34(1):2246604. doi:10.1080/09546634.2023.2246604
27. Patruno C, Fabbrocini G, De Lucia M, Picone V, Genco L, Napolitano M. Psoriasiform dermatitis induced by dupilumab successfully treated with upadacitinib. Dermatol Ther. 2022;35(11):e15788. doi:10.1111/dth.15788
28. Zabotti A, Giovannini I, De Vita S, Stinco G, Errichetti E. Recalcitrant and persistent adalimumab-induced paradoxical psoriasiform skin reaction in a rheumatoid arthritis patient successfully treated with upadacitinib. Dermatologic Therapy. 2022;35(9):e15713. doi:10.1111/dth.15713
29. Gaiani FM, Malagoli P, Carrera CG. Palmoplantar pustulosis successfully treated with upadacitinib: Report of three cases. Australas J Dermatol. 2023;64(4):568-570. doi:10.1111/ajd.14142
30. Rahbar Kooybaran N, Tsianakas A, Assaf K, Mohr J, Wilsmann-Theis D, Mössner R. Response of palmoplantar pustulosis to upadacitinib: A case series of five patients. J Dtsch Dermatol Ges. 2023;21(11):1387-1392. doi:10.1111/ddg.15176
31. Mohr J, Rahbar Kooybaran N, Schön MP, Mössner R. Response of palmoplantar pustulosis to upadacitinib. J Dtsch Dermatol Ges. 2023;21(3):280-282. doi:10.1111/ddg.14969
32. Kimball AB, Ackerman L, Schlosser BJ, et al. 43799 Efficacy and Safety of Upadacitinib in Moderate-to-Severe Hidradenitis Suppurativa: A Phase 2, Randomized, Placebo-Controlled Study. Journal of the American Academy of Dermatology. 2023;89(3, Supplement):AB42. doi:10.1016/j.jaad.2023.07.172
33. Results Posted | A Study of Oral Upadacitinib Tablet Compared to Placebo in Adult Participants With Moderate to Severe Hidradenitis Suppurativa to Assess Change in Disease Symptoms | ClinicalTrials.gov. Accessed February 24, 2024. https://clinicaltrials.gov/study/NCT04430855?term=dermatology&intr=upadacitinib&rank=8&tab=results
34. Patients with hidradenitis suppurativa sustain clearance up to 40 weeks with upadacitinib. Accessed February 24, 2024. https://www.healio.com/news/dermatology/20230322/patients-with-hidradenitis-suppurativa-sustain-clearance-up-to-40-weeks-with-upadacitinib
35. Kozera E, Flora A, Frew JW. Real-world safety and clinical response of Janus kinase inhibitor upadacitinib in the treatment of hidradenitis suppurativa: A retrospective cohort study. J Am Acad Dermatol. 2022;87(6):1440-1442. doi:10.1016/j.jaad.2022.07.047
36. Abu Rached N, Gambichler T, Ocker L, et al. Upadacitinib treatment associated with varicella zoster infection complicated by haemophagocytic lymphohistiocytosis in a patient with severe hidradenitis suppurativa. J Eur Acad Dermatol Venereol. 2024;38(2):e139-e141. doi:10.1111/jdv.19483
37. Study Details | A Study to Assess Change in Disease Activity and Adverse Events of Oral Upadacitinib in Adult and Adolescent Participants With Moderate to Severe Hidradenitis Suppurativa Who Have Failed Anti-TNF Therapy | ClinicalTrials.gov. Accessed November 12, 2023. https://clinicaltrials.gov/study/NCT05889182?cond=Hidradenitis%20Suppurativa&intr=upadacitinib&rank=1
38. Murphy MJ, Gruenstein D, Wang A, et al. Treatment of Persistent Erythema Multiforme With Janus Kinase Inhibition and the Role of Interferon Gamma and Interleukin 15 in Its Pathogenesis. JAMA Dermatol. 2021;157(12):1477-1482. doi:10.1001/jamadermatol.2021.4084
39. Lee JM, Lee YJ, Choi YJ, Lee JH, Choi JE, Han TY. A case of persistent erythema multiforme treated with upadacitinib. The Journal of Dermatology. n/a(n/a). doi:10.1111/1346-8138.16938
40. Deutsch A, Rodriguez N, Roy S, Leventhal JS. Treatment of persistent erythema multiforme with upadacitinib: A novel therapeutic approach. JAAD Case Rep. 2023;34:70-73. doi:10.1016/j.jdcr.2023.02.010
41. Slater KN, Valk B, Kartono F. A case of generalized granuloma annulare treated with upadacitinib. JAAD Case Rep. 2023;34:12-14. doi:10.1016/j.jdcr.2023.01.027
42. Sondermann W, Hadaschik E, Specker C. Successful therapy of disseminated patch-type granuloma annulare with upadacitinib in a patient with rheumatoid arthritis. Dermatologic Therapy. 2022;35(1):e15211. doi:10.1111/dth.15211
43. Balestri R, Bortolotti R, Rech G, Girardelli CR, Zorzi MG, Magnano M. Treatment of Oral Erosive Lichen Planus With Upadacitinib. JAMA Dermatology. 2022;158(4):457-458. doi:10.1001/jamadermatol.2022.0147
44. Kooybaran NR, Petzold G, Ströbel P, Schön MP, Mössner R. Alleviation of erosive oral and esophageal lichen planus by the JAK1 inhibitor upadacitinib. J Dtsch Dermatol Ges. 2021;19(12):1778-1780. doi:10.1111/ddg.14612
45. Van Eycken L, Dens AC, de Vlam K, Neerinckx B, De Haes P. Resolution of therapy-resistant pyoderma gangrenosum with upadacitinib. JAAD Case Rep. 2023;37:89-91. doi:10.1016/j.jdcr.2023.05.016
46. Kooybaran NR, Korsten P, Schön MP, Mössner R. Response of rheumatoid arthritis-associated pyoderma gangrenous to the JAK1 inhibitor upadacitinib. JDDG: Journal der Deutschen Dermatologischen Gesellschaft. 2022;20(4):522-524. doi:10.1111/ddg.14716
47. Song EJ, Al-Saedy MA, Bouché N. Refractory pityriasis rubra pilaris treated with upadacitinib. JAAD Case Rep. 2023;35:112-114. doi:10.1016/j.jdcr.2023.03.004
48. Saad M, Spurr A, Lipson J. Pityriasis rubra pilaris partially responsive to treatment with upadacitinib: A case report. SAGE Open Med Case Rep. 2023;11:2050313X231160927. doi:10.1177/2050313X231160927
49. Su X, Luo R, Ruan S, et al. Efficacy and tolerability of oral upadacitinib monotherapy in patients with recalcitrant vitiligo. Journal of the American Academy of Dermatology. Published online July 28, 2023. doi:10.1016/j.jaad.2023.07.1016
50. Pan T, Mu Y, Shi X, Chen L. Concurrent vitiligo and atopic dermatitis successfully treated with upadacitinib: a case report. J Dermatolog Treat. 2023;34(1):2200873. doi:10.1080/09546634.2023.2200873
51. Study Details | Study to Evaluate Adverse Events and Change in Disease Activity With Oral Tablets of Upadacitinib in Adult Participants With Non-Segmental Vitiligo | ClinicalTrials.gov. Accessed February 24, 2024. https://clinicaltrials.gov/study/NCT04927975?term=dermatology&intr=upadacitinib&rank=9
52. Nash D, Kirchhof MG. Bullous pemphigoid treated with Janus kinase inhibitor upadacitinib. JAAD Case Rep. 2022;32:81-83. doi:10.1016/j.jdcr.2022.12.006
53. Gresham LM, Kirchhof MG. A case of drug-induced bullous pemphigoid secondary to immunotherapy treated with upadacitinib: A case report. SAGE Open Med Case Rep. 2023;11:2050313X231160926. doi:10.1177/2050313X231160926
54. Gil-Lianes J, Morgado-Carrasco D, Riquelme-Mc Loughlin C. Treatment of chronic prurigo with upadacitinib: A case series. Journal of the European Academy of Dermatology and Venereology. n/a(n/a). doi:10.1111/jdv.19462
55. Muntaner-Virgili C, Moreno-Vilchez C, Torrecilla-Vall-Llossera C, Figueras-Nart I. Upadacitinib for prurigo nodularis: A case report. JAAD Case Reports. Published online March 2023:S235251262300070X. doi:10.1016/j.jdcr.2023.01.037
56. Guenin S, Shah S, Lebwohl M. Oral Jak Inhibitor Upadacitinib Use in Treatment of Pemphigus Foliaceus : Case Report. SKIN The Journal of Cutaneous Medicine. 2023;7(4):881-885. doi:10.25251/skin.7.4.5
57. Solimani F, Dilling A, Ghoreschi FC, Nast A, Ghoreschi K, Meier K. Upadacitinib for treatment-resistant Lichen amyloidosis. J Eur Acad Dermatol Venereol. 2023;37(5):e633-e635. doi:10.1111/jdv.18756
58. Li X, Han B, Li S. Treatment of Netherton Syndrome with Upadacitinib. Clinical and Experimental Dermatology. Published online July 21, 2023:llad242. doi:10.1093/ced/llad242
59. Wachuku CI, Barrera T, Jackson T, Sow Y, Mollanazar N, Taylor SC. Upadacitinib as a treatment for chronic pruritus secondary to polycythemia vera after failure with dupilumab. JAAD Case Rep. 2023;35:87-89. doi:10.1016/j.jdcr.2023.02.024
60. Castillo DE, Romanelli P, Lev-Tov H, Kerdel F. A case of erythrodermic mycosis fungoides responding to upadacitinib. JAAD Case Rep. 2022;30:91-93. doi:10.1016/j.jdcr.2022.10.010
61. Murphy LE, Ch’en P, Song EJ. Refractory Hailey-Hailey Disease Cleared with Upadacitinib. JAAD Case Reports. 2023;0(0). doi:10.1016/j.jdcr.2023.09.011
62. Caudrelier N, Veillette H. Acne keloidalis nuchae in a patient with atopic dermatitis treated with Janus kinase inhibitor upadacitinib. JAAD Case Reports. 2023;38:70-71. doi:10.1016/j.jdcr.2023.06.014
63. Kim N, Jue MS, Huh YJ, et al. Epidermolysis bullosa pruriginosa with extensive truncal involvement treated with upadacitinib. J Eur Acad Dermatol Venereol. 2023;37(2):e215-e217. doi:10.1111/jdv.18487
64. Padda IS, Bhatt R, Parmar M. Upadacitinib. In: StatPearls. StatPearls Publishing; 2024. Accessed February 19, 2024. http://www.ncbi.nlm.nih.gov/books/NBK572088/
65. Murphy MJ, Gruenstein D, Wang A, et al. Treatment of Persistent Erythema Multiforme With Janus Kinase Inhibition and the Role of Interferon Gamma and Interleukin 15 in Its Pathogenesis. JAMA Dermatol. 2021;157(12):1-6. doi:10.1001/jamadermatol.2021.4084
66. Fournier C, Sauder MB, Kamil ZS, Butler MO. Kaposi sarcoma in a patient treated with upadacitinib for rheumatoid arthritis. JAAD Case Rep. 2023;39:145-149. doi:10.1016/j.jdcr.2023.07.019
67. Ikumi N, Fujita H, Wada TT. Generalized pustular psoriasis occurred immediately after the withdrawal of upadacitinib in a patient with plaque psoriasis with inflammatory arthritis. J Dermatol. 2023;50(12):e398-e399. doi:10.1111/1346-8138.16901
2. Tofacitinib - an overview | ScienceDirect Topics. Accessed February 24, 2024. https://www.sciencedirect.com/topics/chemistry/tofacitinib#
3. Damsky W, King BA. JAK inhibitors in dermatology: The promise of a new drug class. J Am Acad Dermatol. 2017;76(4):736-744. doi:10.1016/j.jaad.2016.12.005
4. Ciechanowicz P, Rakowska A, Sikora M, Rudnicka L. JAK-inhibitors in dermatology: current evidence and future applications. J Dermatolog Treat. 2019;30(7):648-658. doi:10.1080/09546634.2018.1546043
5. Yu V, Pistillo J, Archibeque I, et al. Differential selectivity of JAK2 inhibitors in enzymatic and cellular settings. Experimental Hematology. 2013;41(5):491-500. doi:10.1016/j.exphem.2013.01.005
6. U.S. FDA Approves RINVOQ® (upadacitinib) as a Once-Daily Pill for Moderately to Severely Active Crohn’s Disease in Adults. AbbVie News Center. Accessed February 24, 2024. https://news.abbvie.com/2023-05-18-U-S-FDA-Approves-RINVOQ-R-upadacitinib-as-a-Once-Daily-Pill-for-Moderately-to-Severely-Active-Crohns-Disease-in-Adults
7. Blair HA. Ritlecitinib: First Approval. Drugs. 2023;83(14):1315-1321. doi:10.1007/s40265-023-01928-y
8. Freitas E, Guttman-Yassky E, Torres T. Baricitinib for the Treatment of Alopecia Areata. Drugs. 2023;83(9):761-770. doi:10.1007/s40265-023-01873-w
9. Johnston LA, Poelman SM. Upadacitinib for management of recalcitrant alopecia areata: A retrospective case series. JAAD Case Rep. 2023;35:38-42. doi:10.1016/j.jdcr.2023.02.019
10. Cantelli M, Martora F, Patruno C, Nappa P, Fabbrocini G, Napolitano M. Upadacitinib improved alopecia areata in a patient with atopic dermatitis: A case report. Dermatol Ther. 2022;35(4):e15346. doi:10.1111/dth.15346
11. Asfour L, Getsos Colla T, Moussa A, Sinclair RD. Concurrent chronic alopecia areata and severe atopic dermatitis successfully treated with upadacitinib. International Journal of Dermatology. 2022;61(11):e416-e417. doi:10.1111/ijd.16316
12. Walls B, Reguiai Z. Dual efficacy of upadacitinib in a patient with concomitant severe atopic dermatitis and alopecia areata. Annales de Dermatologie et de Vénéréologie. Published online June 27, 2023. doi:10.1016/j.annder.2023.03.010
13. Bourkas AN, Sibbald C. Upadacitinib for the treatment of alopecia areata and severe atopic dermatitis in a paediatric patient: A case report. SAGE Open Med Case Rep. 2022;10:2050313X221138452. doi:10.1177/2050313X221138452
14. Novielli D, Foti C, Principi M, et al. Upadacitinib in concurrent Crohn’s disease, atopic dermatitis and alopecia areata: A case report. Journal of the European Academy of Dermatology and Venereology. n/a(n/a). doi:10.1111/jdv.19377
15. Gori N, Cappilli S, Di Stefani A, Tassone F, Chiricozzi A, Peris K. Assessment of alopecia areata universalis successfully treated with upadacitinib. Int J Dermatol. 2023;62(2):e61-e63. doi:10.1111/ijd.16342
16. Youssef S, Bordone LA. Effective treatment of alopecia universalis with oral upadacitinib. JAAD Case Rep. 2022;31:80-82. doi:10.1016/j.jdcr.2022.08.014
17. YU D, REN Y. Upadacitinib for Successful Treatment of Alopecia Universalis in a Child: A Case Report and Literature Review. Acta Derm Venereol. 2023;103:5578. doi:10.2340/actadv.v103.5578
18. Johnston LA, Lu C, Poelman SM. Successful treatment of concomitant alopecia universalis and Crohn’s disease with upadacitinib: A case report. SAGE Open Med Case Rep. 2023;11:2050313X231160914. doi:10.1177/2050313X231160914
19. Kołcz K, Żychowska M, Sawińska E, Reich A. Alopecia Universalis in an Adolescent Successfully Treated with Upadacitinib-A Case Report and Review of the Literature on the Use of JAK Inhibitors in Pediatric Alopecia Areata. Dermatol Ther (Heidelb). 2023;13(3):843-856. doi:10.1007/s13555-023-00889-0
20. Flora A, Kozera E, Frew JW. Treatment of alopecia areata with the janus kinase inhibitor upadacitinib: A retrospective cohort study. Journal of the American Academy of Dermatology. 2023;89(1):137-138. doi:10.1016/j.jaad.2022.12.056
21. Johnston LA, Poelman SM. Upadacitinib for management of recalcitrant alopecia areata: A retrospective case series. JAAD Case Rep. 2023;35:38-42. doi:10.1016/j.jdcr.2023.02.019
22. Study Details | A Study to Evaluate the Safety and Effectiveness of Upadacitinib Tablets in Adult and Adolescent Participants With Severe Alopecia Areata | ClinicalTrials.gov. Accessed November 12, 2023. https://clinicaltrials.gov/study/NCT06012240?cond=Alopecia%20Areata&intr=upadacitinib&rank=1
23. Mease PJ, Lertratanakul A, Papp KA, et al. Upadacitinib in Patients with Psoriatic Arthritis and Inadequate Response to Biologics: 56-Week Data from the Randomized Controlled Phase 3 SELECT-PsA 2 Study. Rheumatol Ther. 2021;8(2):903-919. doi:10.1007/s40744-021-00305-z
24. Gargiulo L, Ibba L, Pavia G, et al. Upadacitinib for the treatment of concomitant psoriasis and atopic dermatitis: a case series. Journal of Dermatological Treatment. 2023;34(1):2183729. doi:10.1080/09546634.2023.2183729
25. Martinez-Molina M, Lluch-Galcerá JJ, Carrascosa JM. Response to upadacitinib in a patient with palmoplantar psoriasis. Eur J Dermatol. 2023;33(3):301-302. doi:10.1684/ejd.2023.4489
26. Wang N, Yang Q, Liu Y, Liu H. Upadacitinib in nail psoriasis: a case report. J Dermatolog Treat. 2023;34(1):2246604. doi:10.1080/09546634.2023.2246604
27. Patruno C, Fabbrocini G, De Lucia M, Picone V, Genco L, Napolitano M. Psoriasiform dermatitis induced by dupilumab successfully treated with upadacitinib. Dermatol Ther. 2022;35(11):e15788. doi:10.1111/dth.15788
28. Zabotti A, Giovannini I, De Vita S, Stinco G, Errichetti E. Recalcitrant and persistent adalimumab-induced paradoxical psoriasiform skin reaction in a rheumatoid arthritis patient successfully treated with upadacitinib. Dermatologic Therapy. 2022;35(9):e15713. doi:10.1111/dth.15713
29. Gaiani FM, Malagoli P, Carrera CG. Palmoplantar pustulosis successfully treated with upadacitinib: Report of three cases. Australas J Dermatol. 2023;64(4):568-570. doi:10.1111/ajd.14142
30. Rahbar Kooybaran N, Tsianakas A, Assaf K, Mohr J, Wilsmann-Theis D, Mössner R. Response of palmoplantar pustulosis to upadacitinib: A case series of five patients. J Dtsch Dermatol Ges. 2023;21(11):1387-1392. doi:10.1111/ddg.15176
31. Mohr J, Rahbar Kooybaran N, Schön MP, Mössner R. Response of palmoplantar pustulosis to upadacitinib. J Dtsch Dermatol Ges. 2023;21(3):280-282. doi:10.1111/ddg.14969
32. Kimball AB, Ackerman L, Schlosser BJ, et al. 43799 Efficacy and Safety of Upadacitinib in Moderate-to-Severe Hidradenitis Suppurativa: A Phase 2, Randomized, Placebo-Controlled Study. Journal of the American Academy of Dermatology. 2023;89(3, Supplement):AB42. doi:10.1016/j.jaad.2023.07.172
33. Results Posted | A Study of Oral Upadacitinib Tablet Compared to Placebo in Adult Participants With Moderate to Severe Hidradenitis Suppurativa to Assess Change in Disease Symptoms | ClinicalTrials.gov. Accessed February 24, 2024. https://clinicaltrials.gov/study/NCT04430855?term=dermatology&intr=upadacitinib&rank=8&tab=results
34. Patients with hidradenitis suppurativa sustain clearance up to 40 weeks with upadacitinib. Accessed February 24, 2024. https://www.healio.com/news/dermatology/20230322/patients-with-hidradenitis-suppurativa-sustain-clearance-up-to-40-weeks-with-upadacitinib
35. Kozera E, Flora A, Frew JW. Real-world safety and clinical response of Janus kinase inhibitor upadacitinib in the treatment of hidradenitis suppurativa: A retrospective cohort study. J Am Acad Dermatol. 2022;87(6):1440-1442. doi:10.1016/j.jaad.2022.07.047
36. Abu Rached N, Gambichler T, Ocker L, et al. Upadacitinib treatment associated with varicella zoster infection complicated by haemophagocytic lymphohistiocytosis in a patient with severe hidradenitis suppurativa. J Eur Acad Dermatol Venereol. 2024;38(2):e139-e141. doi:10.1111/jdv.19483
37. Study Details | A Study to Assess Change in Disease Activity and Adverse Events of Oral Upadacitinib in Adult and Adolescent Participants With Moderate to Severe Hidradenitis Suppurativa Who Have Failed Anti-TNF Therapy | ClinicalTrials.gov. Accessed November 12, 2023. https://clinicaltrials.gov/study/NCT05889182?cond=Hidradenitis%20Suppurativa&intr=upadacitinib&rank=1
38. Murphy MJ, Gruenstein D, Wang A, et al. Treatment of Persistent Erythema Multiforme With Janus Kinase Inhibition and the Role of Interferon Gamma and Interleukin 15 in Its Pathogenesis. JAMA Dermatol. 2021;157(12):1477-1482. doi:10.1001/jamadermatol.2021.4084
39. Lee JM, Lee YJ, Choi YJ, Lee JH, Choi JE, Han TY. A case of persistent erythema multiforme treated with upadacitinib. The Journal of Dermatology. n/a(n/a). doi:10.1111/1346-8138.16938
40. Deutsch A, Rodriguez N, Roy S, Leventhal JS. Treatment of persistent erythema multiforme with upadacitinib: A novel therapeutic approach. JAAD Case Rep. 2023;34:70-73. doi:10.1016/j.jdcr.2023.02.010
41. Slater KN, Valk B, Kartono F. A case of generalized granuloma annulare treated with upadacitinib. JAAD Case Rep. 2023;34:12-14. doi:10.1016/j.jdcr.2023.01.027
42. Sondermann W, Hadaschik E, Specker C. Successful therapy of disseminated patch-type granuloma annulare with upadacitinib in a patient with rheumatoid arthritis. Dermatologic Therapy. 2022;35(1):e15211. doi:10.1111/dth.15211
43. Balestri R, Bortolotti R, Rech G, Girardelli CR, Zorzi MG, Magnano M. Treatment of Oral Erosive Lichen Planus With Upadacitinib. JAMA Dermatology. 2022;158(4):457-458. doi:10.1001/jamadermatol.2022.0147
44. Kooybaran NR, Petzold G, Ströbel P, Schön MP, Mössner R. Alleviation of erosive oral and esophageal lichen planus by the JAK1 inhibitor upadacitinib. J Dtsch Dermatol Ges. 2021;19(12):1778-1780. doi:10.1111/ddg.14612
45. Van Eycken L, Dens AC, de Vlam K, Neerinckx B, De Haes P. Resolution of therapy-resistant pyoderma gangrenosum with upadacitinib. JAAD Case Rep. 2023;37:89-91. doi:10.1016/j.jdcr.2023.05.016
46. Kooybaran NR, Korsten P, Schön MP, Mössner R. Response of rheumatoid arthritis-associated pyoderma gangrenous to the JAK1 inhibitor upadacitinib. JDDG: Journal der Deutschen Dermatologischen Gesellschaft. 2022;20(4):522-524. doi:10.1111/ddg.14716
47. Song EJ, Al-Saedy MA, Bouché N. Refractory pityriasis rubra pilaris treated with upadacitinib. JAAD Case Rep. 2023;35:112-114. doi:10.1016/j.jdcr.2023.03.004
48. Saad M, Spurr A, Lipson J. Pityriasis rubra pilaris partially responsive to treatment with upadacitinib: A case report. SAGE Open Med Case Rep. 2023;11:2050313X231160927. doi:10.1177/2050313X231160927
49. Su X, Luo R, Ruan S, et al. Efficacy and tolerability of oral upadacitinib monotherapy in patients with recalcitrant vitiligo. Journal of the American Academy of Dermatology. Published online July 28, 2023. doi:10.1016/j.jaad.2023.07.1016
50. Pan T, Mu Y, Shi X, Chen L. Concurrent vitiligo and atopic dermatitis successfully treated with upadacitinib: a case report. J Dermatolog Treat. 2023;34(1):2200873. doi:10.1080/09546634.2023.2200873
51. Study Details | Study to Evaluate Adverse Events and Change in Disease Activity With Oral Tablets of Upadacitinib in Adult Participants With Non-Segmental Vitiligo | ClinicalTrials.gov. Accessed February 24, 2024. https://clinicaltrials.gov/study/NCT04927975?term=dermatology&intr=upadacitinib&rank=9
52. Nash D, Kirchhof MG. Bullous pemphigoid treated with Janus kinase inhibitor upadacitinib. JAAD Case Rep. 2022;32:81-83. doi:10.1016/j.jdcr.2022.12.006
53. Gresham LM, Kirchhof MG. A case of drug-induced bullous pemphigoid secondary to immunotherapy treated with upadacitinib: A case report. SAGE Open Med Case Rep. 2023;11:2050313X231160926. doi:10.1177/2050313X231160926
54. Gil-Lianes J, Morgado-Carrasco D, Riquelme-Mc Loughlin C. Treatment of chronic prurigo with upadacitinib: A case series. Journal of the European Academy of Dermatology and Venereology. n/a(n/a). doi:10.1111/jdv.19462
55. Muntaner-Virgili C, Moreno-Vilchez C, Torrecilla-Vall-Llossera C, Figueras-Nart I. Upadacitinib for prurigo nodularis: A case report. JAAD Case Reports. Published online March 2023:S235251262300070X. doi:10.1016/j.jdcr.2023.01.037
56. Guenin S, Shah S, Lebwohl M. Oral Jak Inhibitor Upadacitinib Use in Treatment of Pemphigus Foliaceus : Case Report. SKIN The Journal of Cutaneous Medicine. 2023;7(4):881-885. doi:10.25251/skin.7.4.5
57. Solimani F, Dilling A, Ghoreschi FC, Nast A, Ghoreschi K, Meier K. Upadacitinib for treatment-resistant Lichen amyloidosis. J Eur Acad Dermatol Venereol. 2023;37(5):e633-e635. doi:10.1111/jdv.18756
58. Li X, Han B, Li S. Treatment of Netherton Syndrome with Upadacitinib. Clinical and Experimental Dermatology. Published online July 21, 2023:llad242. doi:10.1093/ced/llad242
59. Wachuku CI, Barrera T, Jackson T, Sow Y, Mollanazar N, Taylor SC. Upadacitinib as a treatment for chronic pruritus secondary to polycythemia vera after failure with dupilumab. JAAD Case Rep. 2023;35:87-89. doi:10.1016/j.jdcr.2023.02.024
60. Castillo DE, Romanelli P, Lev-Tov H, Kerdel F. A case of erythrodermic mycosis fungoides responding to upadacitinib. JAAD Case Rep. 2022;30:91-93. doi:10.1016/j.jdcr.2022.10.010
61. Murphy LE, Ch’en P, Song EJ. Refractory Hailey-Hailey Disease Cleared with Upadacitinib. JAAD Case Reports. 2023;0(0). doi:10.1016/j.jdcr.2023.09.011
62. Caudrelier N, Veillette H. Acne keloidalis nuchae in a patient with atopic dermatitis treated with Janus kinase inhibitor upadacitinib. JAAD Case Reports. 2023;38:70-71. doi:10.1016/j.jdcr.2023.06.014
63. Kim N, Jue MS, Huh YJ, et al. Epidermolysis bullosa pruriginosa with extensive truncal involvement treated with upadacitinib. J Eur Acad Dermatol Venereol. 2023;37(2):e215-e217. doi:10.1111/jdv.18487
64. Padda IS, Bhatt R, Parmar M. Upadacitinib. In: StatPearls. StatPearls Publishing; 2024. Accessed February 19, 2024. http://www.ncbi.nlm.nih.gov/books/NBK572088/
65. Murphy MJ, Gruenstein D, Wang A, et al. Treatment of Persistent Erythema Multiforme With Janus Kinase Inhibition and the Role of Interferon Gamma and Interleukin 15 in Its Pathogenesis. JAMA Dermatol. 2021;157(12):1-6. doi:10.1001/jamadermatol.2021.4084
66. Fournier C, Sauder MB, Kamil ZS, Butler MO. Kaposi sarcoma in a patient treated with upadacitinib for rheumatoid arthritis. JAAD Case Rep. 2023;39:145-149. doi:10.1016/j.jdcr.2023.07.019
67. Ikumi N, Fujita H, Wada TT. Generalized pustular psoriasis occurred immediately after the withdrawal of upadacitinib in a patient with plaque psoriasis with inflammatory arthritis. J Dermatol. 2023;50(12):e398-e399. doi:10.1111/1346-8138.16901
Article Sidebar
Published
Jul 23, 2024
Article Details
How to Cite
Amara, S., Sapoznik, A., Guenin, S. ., Kodali, N. ., & Lebwohl, M. . (2024). Off-Label Uses of Upadacitinib . SKIN The Journal of Cutaneous Medicine, 8(4), 1614–1643. https://doi.org/10.25251/skin.8.4.1
Section
In-Depth Reviews
This work is licensed under a Creative Commons Attribution 4.0 International License.
All authors retain copyright in their articles. All articles published open access allowing for immediate free access to the work and permitting any user to read, download, copy, distribute, print, search, or link to the full texts of articles, crawl them for indexing, pass them as data to software or use them for any other lawful purpose. Permitted reuse is defined by the following user license:
Creative Commons Attribution (CC BY): lets others distribute and copy the article, to create extracts, abstracts, and other revised versions, adaptations or derivative works of or from an article (such as a translation), to include in a collective work (such as an anthology), to text or data mine the article, even for commercial purposes, as long as they credit the author(s), do not represent the author as endorsing their adaptation of the article, and do not modify the article in such a way as to damage the author's honor or reputation.
Authors retain copyright in their work and license the publisher to publish the content. The publisher is the National Society for Cutaneous Medicine, with production and publishing support provided by OJS, Open Journal Systems,see https://pkp.sfu.
Prior to January 2022, authors transferred copyright to the National Society for Cutaneous Medicine. However, all articles are freely available to anyone in the world. There are no subscription fees, page charges, or article processing charges.