How should the usage and dosage of Upatinib/Refu be regulated?

Upadacitinib is an oral selective Janus kinase 1 (JAK1) inhibitor that is widely used to treat immune-mediated diseases such as rheumatoid arthritis, psoriatic arthritis, atopic dermatitis, ulcerative colitis, and Crohn's disease. It blocks the JAK-STAT signaling pathway and inhibits the abnormal activation of inflammatory factors, thereby effectively relieving joint pain, skin inflammation and intestinal mucosal damage. In order to ensure efficacy and safety, the usage and dosage of upadatinib should be standardized and adjusted according to the indications and individual patient differences.

In patients with rheumatoid arthritis, ankylosing spondylitis and axial spondyloarthritis, the standard recommended dose is 15 mg orally once daily. It is recommended to take it with or without food. For patients with atopic dermatitis, the treatment strategy is more individualized: the starting dose for adults aged 12 years and above and weighing ≥40kg is 15mg per day, which can be increased to 30mg per day if the treatment response is insufficient, while for elderly patients, 15mg can be maintained. The treatment of ulcerative colitis is usually divided into two phases: induction phase and maintenance phase. The induction period is recommended to be 45 mg/day for 8 weeks to quickly control inflammation, and then enter the maintenance period, where 15 mg/day can maintain remission, while severe patients can temporarily increase it to 30 mg.

The dosage for children with psoriatic arthritis needs to be adjusted according to weight stratification. Children between 10 and 20 kg should take 3 mg twice a day; children between 20 and 30 kg should take 4 mg twice a day; children above 30 kg should take 6 mg twice a day. Oral solution dosage forms must be used instead of sustained-release tablets. Adults usually take 15 mg orally once daily. For the treatment of Crohn's disease, the recommended induction phase is 45 mg daily for 12 weeks, followed by a maintenance phase of 15 mg daily. If the condition is more complex or refractory, you can consider increasing it to 30 mg/day. However, if the high dose still has no significant effect, you should stop the drug in time and re-evaluate the treatment plan.

Upadatinib is a highly selective immunomodulatory drug, so the principle of "lowest effective dose and longest safe period" should be followed during use.

Reference materials:https://www.rinvoq.com/