Upadacitinib is in development for the treatment of moderate to severe atopic dermatitis (AD). AD is a chronic inflammatory skin disease that affects both children and adults and is characterised by redness, itchiness, and scaling of the skin. Some people only have small patches of dry skin, but others may experience widespread red, inflamed skin all over the body. Patients with moderate to severe AD may experience sleep disturbances, anxiety, depression, and poor quality of life. Currently, the management of AD involves the removal or treatment of trigger factors that contribute to the development of the disease and topical and/or systemic treatment depending on the severity of the disease.
Upadacitinib acts by selectively blocking a protein called Janus-Associated Kinase 1 (JAK1 and JAK1/3). JAKs contribute to the processes within the cell to produce an immune or inflammatory response. There is an emerging body of evidence establishing that JAK dependent enzymes are major contributors to the progression of immune-mediated diseases such as AD and that blocking such enzymes can be beneficial. Upadacitinib is taken orally and if licensed, it will offer an additional treatment option for patients with moderate to severe AD.
Tralokinumab is a human monoclonal antibody that binds and neutralises the effect of the protein, interleukin 13 (IL-13), which plays a key role in triggering immune system responses in patients leading to AD. Tralokinumab is administered subcutaneously and is currently licenced for the treatment of adults. Evidence from clinical trials suggests an improvement in disease symptoms. If licensed, tralokinumab will offer an additional treatment option for adolescents with moderate to severe AD.