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Upadacitinib (Rinvoq) is a possible treatment option for adults with moderately or severely active ulcerative colitis, who have not responded adequately to, or have stopped responding to, or who cannot tolerate medicines called TNF (tumour necrosis factor) blockers. Find out more about it...
Rinvoq is the brand name for upadacitinib. It’s a type of drug called a JAK (Janus-associated tyrosine kinase) inhibitor used in the treatment of adults with moderately or severely active ulcerative colitis. It is currently licensed for use in the USA by the Food and Drug Administration (FDA) and has approval for NHS use in Scotland (approved by Scottish Medicines Consortium SMC) and in the UK by the National Institute of Health and Care Excellence (NICE).
JAKs are proteins that are involved in activating your immune response, which can cause inflammation in the gut in ulcerative colitis patients. Upadacitinib works to block the effects of JAKs and reduce inflammation. It can help to reduce the symptoms of ulcerative colitis and reduce your need for steroids. It aims to reduce inflammation in the gut, prevent flares and improve symptoms, including bloody stools, abdominal pain, urgency and frequency of bowel movements.
Upadacitinib is recommended as a treatment option for adults with moderately or severely active ulcerative colitis when other inflammatory bowel disease (IBD) treatments, i.e., TNF blockers have been tried but prove unsuccessful.
Before starting upadacitinib you should tell your doctor if you believe you may currently have any infections. Upadacitinib can reduce your body’s ability to fight infections. It may make an existing infection worse or increase the chance of you getting a new infection.
Signs of infection may include fever, sweating, chills, muscle aches, cough, shortness of breath, new phlegm or change in phlegm, weight loss, warm or red or painful skin or sores on your body, difficulty or pain when swallowing, diarrhoea or stomach pain, burning when you urinate or urinating more often than normal, feeling very tired.
You will need blood tests before you start taking upadacitinib, or while you are taking it to check for low red blood cell count (anaemia), low white blood cell count (neutropenia or lymphopenia), high blood fat (cholesterol) or high levels of liver enzymes. The tests are to check that treatment with upadacitinib is not causing problems.
Other considerations are:
You should also tell your doctor if you take any other medications, over-the-counter medicines or vitamins or supplements. It’s also worth noting that food or drink containing grapefruit should be avoided during treatment with upadacitinib as it may increase the risk of side effects by increasing the amount of upadacitinib in your body.
Upadacitinib is in tablet form, usually taken orally once a day, with or without food. You may start with a higher dose for around eight weeks (induction dose) before reducing to a lower daily dose (maintenance dose).
The most common reported side effects of upadacitinib are (also see ‘Who can take upadacitinib?’):
Very common (may affect more than 1 in 10 people):
Common (may affect up to 1 in 10 people):
Uncommon (may affect up to 1 in 100 people):
Upadacitinib may interact with some other medications so it’s important you tell your doctor about any medications you are taking before starting, including over-the-counter medicines and supplements.
Other medicines that may also affect how upadacitinib works are medicines used to treat fungal or bacterial infections, rifampicin or phenytoin and medicines that affect your immune system. Plus, medicines to treat seizures or fits, such as phenytoin.
It’s really important you tell your doctor as there may be other drug interactions not mentioned here. ¹
Rinvoq was developed by the biotech company AbbVie and has received approval for use in treating ulcerative colitis in the USA by the Food and Drug Administration (FDA) and has also received approval from the European Commission and the Scottish Medicines Consortium (SMC) for use by the NHS in Scotland and in the UK by the National Institute of Health and Care Excellence (NICE). It is awaiting review by NICE for use in the treatment of Crohn's disease.
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