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.
Secukinumab as a subcutaneous injection is in clinical development for the treatment of enthesitis related arthritis (ERA) and juvenile psoriatic arthritis (JPsA). These conditions belong to a group of arthritis conditions of unknown cause known as juvenile idiopathic arthritis which affect children. JPsA patients have arthritis and psoriasis, an inflammatory skin disease and ERA patients have arthritis and enthesitis, inflammation of the ligaments and tendons. These conditions are the result of the immune system mistakenly attacking the body’s own cells at the joints and the skin or tendons, causing swelling, pain and reduced mobility.