Efficacy and safety of upadacitinib in psoriatic arthritis

Psoratic arthritis (PsA) is a common disorder affecting every fifth patient with psoriasis. Typical clinical manifestations of PsA include asymmetric mono/oligoathritis or polyarthritis, spondyloarthritis, enthesitis and dactylitis. More rarely PsA is associated with uveitis and inflammatory bowel disease. Upadacitinib is a selective JAK-kinase inhibitor approved for treatment of PsA. Its efficacy and favorable safety profile in PsA patients were established in two randomized placebocontrolled phase 3 clinical trials (SELECT-PsA 1 and 2). In both studies, upadacitinib was significantly more effective than placebo and improved activity of PsA, psoriatic lesions, enthesitis and dactylitis. Moreover, upadacitinib is approved for treatment of axial spondylitis and, therefore, can be used in patients with any manifestations of PsA. The authors present clinical cases of PsA and discuss indications for upadacitinib administration in such patients.