Upadacitinib in dermatology: A systematic review of mechanism, current applications, efficacy, safety, and emerging evidence

Abstract

Upadacitinib, a second-generation oral Janus kinase (JAK) inhibitor, selectively targets the JAK 1 non-receptor protein kinase, effectively modulating downstream inflammatory pathways implicated in a range of dermatological diseases. Its JAK 1 selectivity mitigates unwanted side effects associated with broader JAK inhibition. FDA approval for moderate to severe atopic dermatitis (AD) in January 2022 marked a significant milestone, expanding treatment options in dermatology. Since then, upadacitinib has demonstrated efficacy in various dermatological disorders, contributing to improved patient outcomes. This review aims to spotlight its use in AD, as well as off-label indications in dermatology, its safety and efficacy profile, and pertinent information regarding side effects and contraindications.