Upadacitinib for non-radiographic axial spondyloarthritis

Upadacitinib is in clinical development for the treatment of adults with non-radiographic axial spondyloarthritis (nr-axSpA). This condition affects patients predominantly in the spine and other areas of the body and is caused by inflammation. The inflammation can lead to back pain, fatigue and in serious cases to severe disability as the bones of the spine fuse into a fixed position or joints become progressively damaged. It is characterised by an absence of radiographic sacroilitis which is usually seen in patients with axSpA. Some patients with nraxSpA do not respond well to current treatment options, resulting in a clear unmet medical need.
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 nr-axSpA and that blocking such enzymes can be beneficial. Upadacitinib is taken orally and will offer patients a less invasive option of therapy as currently approved therapies for nr-axSpA are administered either by injections or intravenous infusions.