Rheumatoid arthritis (RA) is a chronic inflammatory condition that primarily affects the joints, including the hands, wrists and knees. The condition may also affect other parts of the body, including the eyes, lungs, heart, blood vessels and skin.
The damage associated with RA is caused by an autoimmune response; that is, when the immune system attacks the body’s own tissues 1. This causes pain and swelling in the lining of the joints, eventually leading to bone erosion and deformity of the joints. The resultant stiffness, pain and loss of balance can, in severe cases, lead to physical disability.
Treatment for RA usually involves the use of medications known as disease-modifying antirheumatic drugs (DMARDs) 2. These help to reduce inflammation, which slows disease progression and may prevent joint deformity. One recently-approved DMARD is RINVOQ (upadacitinib), a biologic drug that has produced promising results in clinical trials for the treatment of RA.
How RINVOQ works
RINVOQ is the brand name for upadacitinib, a biologic drug belonging to a group of medications known as Janus kinase (JAK) inhibitors 3. It works by inhibiting your immune system, decreasing the activity of immune cells to reduce inflammation in the joints. This not only relieves the symptoms associated with RA, but can also help to slow disease progression and prevent the development of joint deformity.
RINVOQ may be prescribed to patients who exhibit an inadequate response to other common RA treatments (such as methotrexate).
Drug Effectiveness & Clinical Trials Results
RINVOQ has produced promising results in recent clinical trials. When compared with adalimumab 4 (a DMARD used to treat RA) and a placebo, upadacitinib was found to be superior to both for improving symptoms and physical function in patients with RA.
When compared with methotrexate 5 (the most commonly used therapy for RA), upadacitinib was found to produce low disease activity and remission in a greater percentage of patients after 24 weeks of treatment. Furthermore, up to 89% of participants were found to have no disease progression following this time period (compared to 78% of patients treated with methotrexate).
Another study 6 involving RA patients with inadequate response to methotrexate showed significant improvement in clinical and functional outcomes after switching to treatment with upadacitinib. Further analysis of clinical trials 7 comparing the use of upadacitinib, adalimumab and methotrexate as treatments for RA have concluded that upadacitinib improved disease activity and treatment outcomes more effectively than both adalimumab and methotrexate.
How RINVOQ Is Administered
RINVOQ medication is administered orally 8 and may be taken with or without food, depending on the recommendation of your doctor. It is usually taken once daily, and should not be crushed, chewed or split, as this can increase the risk of side effects.
RINVOQ Dose Information
The recommended dose is 15mg/day 9. RINVOQ may be prescribed alone or in combination with methotrexate or other non-biologic DMARDs.
Side Effects and Safety of RINVOQ
Upadacinitib can effectively improve the symptoms and disease activity of RA, but may also produce side effects 10. These may require medical attention, and patients taking RINVOQ should consult their doctor if side effects occur.
More common side effects associated with RINVOQ:
- Bodily aches and pain
- Ear congestion
- Skin irritation (including redness, swelling, warmth, itching, pain or tenderness)
- Loss of voice
- Nasal congestion
- Runny nose
- Sore throat
- Unusual levels of fatigue (tiredness or weakness)
Less common side effects associated with RINVOQ:
- Black, tarry stools
- Burning or stinging of the skin
- Lower back pain
- Side pain
- Painful blisters on the torso
- Painful sores or blisters on the lips, eyes, nose or genitals
- Painful or difficult urination
- Pale skin
- Ulcers, sores or white spots inside the mouth
- Unusual bleeding or bruising
Rare side effects associated with RINVOQ:
- Coughing up blood
- Difficulty breathing (with or without exertion)
- Muscle pain
- Night sweats
- Persistent, non-healing sores
- Severe abdominal or stomach pain, cramping or burning
- Shiny bumps on the skin
- Sudden high fever or low-grade fever that persists for months
- Severe vomiting of dark, grainy material (that looks like coffee grounds)
- White, yellow or waxy scar-like areas on the skin
RINVOQ Drug Interactions
Always consult with your doctor about the use of RINVOQ in combination with other treatments. RINVOQ may be prescribed alongside other medications, but should not be taken in combination with certain other drugs.
These include 11:
- Tofacitinib (Xeljanz)
- Azathioprine (Azasan)
- Cyclosporine (Sandimmune, Neoral, Gengraf)
- Infliximab (Remicade)
- Adalimumab (Humira)
RINVOQ can be used alongside methotrexate, hydroxychloroquine (Plaquenil) and leflunomide (Arava).
How Much Does RINVOQ Cost?
The cost of RINVOQ 15mg oral tablets is around $5142 USD for a 30-day supply 12.
Medicare patients may be eligible to receive free RINVOQ 13 if:
- They have been prescribed RINVOQ by a doctor
- They have limited or no health insurance
- They live in the United States
- They are being treated as an outpatient by a licensed U.S healthcare provider
Is RINVOQ Covered by Medicare?
To find out if your RINVOQ prescription can be covered by Medicare (or Medicaid), call 1.800.2RINVOQ (1.800.274.6867) 14 for information.
Reumatoid Arthritis Clinical Trials
- Long-term Safety and Efficacy of GSK3196165 (Otilimab) in the Treatment of Rheumatoid Arthritis (RA) - United States
- Study to Assess Safety and Effectiveness of Branebrutinib Treatment in Participants With Active Systemic Lupus Erythematosus or Primary Sjögren's Syndrome, or Branebrutinib Treatment Followed by Open-label Abatacept Treatment in Study Participants With Active Rheumatoid Arthritis - Worldwide
- The Effect of Guided Care With Vectra DA Compared to Treatment as Usual in Patients With Rheumatoid Arthritis - United States
- A Study of Baricitinib (LY3009104) in Participants With Rheumatoid Arthritis - Worldwide
- Cardiovascular Risk Assessment for Patients With Rheumatoid Arthritis Arthritis - New York, New York, United States
Quick Facts About Rheumatoid Arthritis
- Rheumatoid arthritis is the most common form of autoimmune arthritis. It is caused when the body’s immune system attacks healthy tissues.
- Rheumatoid arthritis causes inflammation in the lining of the joints, leading to stiffness, pain, swelling, loss of balance and loss of mobility. It most commonly affects the hands, wrists, knees and ankles and, in severe cases, can lead to joint deformity.
- Although rheumatoid arthritis usually affects the joints, it can also cause problems in other parts of the body, such as the eyes, heart, blood vessels and lungs.
- Women are around three times more likely to develop rheumatoid arthritis than men.
- Generally, rheumatoid arthritis affects women at a younger age than men, and is more likely to result in a greater number of symptoms, and more severe symptoms. Women with RA are also less likely to achieve disease remission than men with RA.
- Rheumatoid arthritis affects approximately 0.3 – 1% of people worldwide.
- Most people with rheumatoid arthritis are diagnosed between the ages of 20 and 40.
- The exact causes of rheumatoid arthritis are unknown, but known risk factors include age, family medical history, environmental factors, genetics, obesity and cigarette smoking.
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