Upadacitinib is a selective Janus kinase (JAK) inhibitor which is approved by the US Food and Drug Administration, the European Medicines Agency, as well as other agencies around the world for the treatment of several chronic inflammatory diseases, including rheumatic, dermatologic, and gastrointestinal diseases. Through inhibition of JAK, upadacitinib inhibits phosphorylation of downstream effector proteins, which consequently inhibits cytokine signaling for key pathways involved in inflammatory diseases. Upadacitinib more potently inhibits JAK1 than other JAK isoforms. The pharmacokinetics, pharmacodynamics, efficacy, and safety of upadacitinib were characterized in many clinical trials, which demonstrated the superiority of upadacitinib treatment over placebo or an active comparator in rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, non-radiographic axial spondyloarthritis, atopic dermatitis, Crohn's disease, and ulcerative colitis. The safety profile of upadacitinib supported a favorable benefit–risk profile across all the approved indications. In this article, we review the mechanism of action of upadacitinib and describe how the JAK–STAT (Janus kinase–signal transducers and activators of transcription) pathway is involved in the pathogenesis of several chronic and progressive immune-mediated inflammatory diseases. In addition, this review also provides an overview of key clinical trials that were conducted as well as relevant data which supported the clinical development of upadacitinib and informed the recommended dose(s) in each of the approved indications.

中文翻译：

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Upadacitinib：作用机制、临床和转化科学


Upadacitinib是一种选择性Janus激酶（JAK）抑制剂，已获得美国食品和药物管理局、欧洲药品管理局以及世界各地其他机构的批准，用于治疗多种慢性炎症性疾病，包括风湿病、皮肤病和胃肠道疾病疾病。通过抑制 JAK，upadacitinib 可抑制下游效应蛋白的磷酸化，从而抑制炎症性疾病关键通路的细胞因子信号传导。 Upadacitinib 比其他 JAK 亚型更有效地抑制 JAK1。许多临床试验对乌帕替尼的药代动力学、药效学、疗效和安全性进行了表征，这些试验证明了乌帕替尼治疗类风湿性关节炎、银屑病关节炎、强直性脊柱炎、非放射学中轴​​型脊柱关节炎、特应性皮炎等疾病的治疗优于安慰剂或活性对照药。克罗恩病和溃疡性结肠炎。 upadacitinib 的安全性在所有批准的适应症中都支持良好的获益-风险状况。在本文中，我们回顾了upadacitinib的作用机制，并描述了JAK-STAT（Janus激酶-信号转导子和转录激活子）通路如何参与几种慢性和进行性免疫介导的炎症性疾病的发病机制。此外，本综述还概述了已进行的关键临床试验以及支持 upadacitinib 临床开发的相关数据，并告知了每个已批准适应症的推荐剂量。