FDA Approves Rinvoq for Adults and Children 12 Years and Older with Refractory, Moderate to Severe AD
The JAK inhibitor is already approved for the treatment of rheumatoid arthritis and psoriatic arthritis.
The FDA has given its nod to AbbVie’s Rinvoq (upadacitinib) for the treatment of moderate to severe atopic dermatitis in adults and children 12 years of age and older whose disease did not respond to previous treatment and is not well controlled with other pills or injections, including biologic medicines, or when use of other pills or injections is not recommended.
The JAK inhibitor is already approved for the treatment of rheumatoid arthritis and psoriatic arthritis.
Rinvoq 15mg once daily can be initiated in adults and children 12 years of age and older weighing at least 40kg. 1 In these children and adults less than 65 years of age who do not achieve an adequate response, the dose may be increased to 30mg once daily.
“Early in my career as an allergist, I saw how relentless the itch and rash could be for my patients with moderate to severe atopic dermatitis yet had limited options to offer those whose disease could not be adequately controlled with systemic therapy,” says Thomas Hudson, MD, senior vice president, research and development, chief scientific officer, AbbVie, in a news release. “This additional approval for Rinvoq provides a once-daily oral option that can significantly improve the debilitating itch and skin symptoms of atopic dermatitis. It’s also a proud moment for AbbVie as we continue our efforts to improve care in this disease state and other chronic, immune- mediated conditions.”
The FDA approval is supported by efficacy and safety data from one of the largest registrational Phase 3 programs for atopic dermatitis with more than 2,500 patients evaluated across three studies. Approximately 52 percent of the patients had prior exposure to systemic atopic dermatitis treatment. These studies evaluated the efficacy and safety of Rinvoq monotherapy (Measure Up 1 and 2) and with topical corticosteroids (AD Up), compared to placebo, in adults and children 12 years of age and older with moderate to severe atopic dermatitis.
“Despite available therapies, many people with moderate to severe atopic dermatitis are caught in an endless cycle of itching and scratching,” says Emma Guttman-Yassky, MD, PhD, Waldman Professor and System Chair of Dermatology at the Icahn School of Medicine at Mount Sinai in New York City. “In clinical trials, upadacitinib showed a robust response across skin and itch symptoms that may help evolve treatment goals for those who have not achieved adequate control of their disease. And as an oral pill with two dose strengths, upadacitinib is a welcome addition to the toolbox of clinicians who are striving to make a significant difference for their patients with moderate to severe atopic dermatitis.”
Across the three atopic dermatitis pivotal studies, Rinvoq (15mg and 30mg, once daily) monotherapy and with topical corticosteroids met all primary and secondary endpoints at week 16, with some patients achieving higher levels of skin clearance (EASI 90 and 100).
In all three studies, a significant improvement in itch (Worst Pruritus NRS ≥4) was observed as early as week one, compared to placebo.
Rinvoq may cause serious side effects, including:
Serious infections. Rinvoq can lower your ability to figh tinfections. Serious nfections have happened while taking Rinvoq, including tuberculosis (TB) and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections.
Increased risk of death in people 50 years and older with at least 1 heart disease (cardiovascular) risk factor.
Cancer and immune system problems. Rinvoq may increase your riskof certain cancers, including lymphoma, skin, and lung cancer, as these can happen. Current or past smokers are at higher risk.
Increased risk of major cardiovascular events such as heart attack,stroke, or death in people 50 years and older with at least 1 heart disease (cardiovascular) risk factor, especially in current or past smokers.
Overall, the safety profile observed in patients with atopic dermatitis treated with Rinvoq 15 mg or 30 mg was similar to the safety profile observed in patients with rheumatoid arthritis. Other specific adverse reactions reported in atopic dermatitis patients included eczema herpeticum/Kaposi’s varicelliform eruption. Blood clots in the veins of the legs or lungs and arteries can happen with Rinvoq. This may be life-threatening and cause death. This has happened more often in people 50 years and older with at least 1 heart disease (cardiovascular) risk factor.
The FDA requires boxed warnings about increased risk of serious heart-related events, cancer, blood clots, and death for JAK inhibitors that treat certain chronic inflammatory conditions.
AbbVie is committed to helping people access Rinvoq and other medicines, including offering a patient support program and a co-pay card that may reduce out-of-pocket costs to as little as $5 per month for eligible, commercially-insured patients. For those with limited or no health insurance, AbbVie offers myAbbVie Assist, a patient assistance program that provides Rinvoq at no charge to those who qualify. More information about this assistance program can be found on www.AbbVie.com/myAbbVieAssist.
“Every person with atopic dermatitis has a unique experience with their disease, and in turn, must have multiple options to choose from in their journey to find a treatment that meets their individual needs,” says Julie Block, president and chief executive officer, National Eczema Association. “This approval is a significant milestone for our community, providing an additional therapy that may bring relief to those living with the devastating symptoms of moderate to severe atopic dermatitis.”