Upadacitinib — SCE Dermatology MCQ
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Correct answer: E — Selective oral JAK1 inhibitor
Upadacitinib is a selective oral JAK1 inhibitor approved for atopic eczema (and RA/PsA). By preferentially inhibiting JAK1, it blocks signalling of multiple inflammatory cytokines (IL-4, IL-13, IL-31, IL-22, TSLP) without broadly suppressing JAK2 (which mediates erythropoietin and thrombopoietin signalling) or JAK3. The SELECT-AD trials demonstrated rapid itch reduction and significant EASI improvement. Safety monitoring includes FBC, LFTs, lipids, and screening for TB/hepatitis before starting. JAK inhibitor class warnings include VTE, MACE, malignancy, and serious infection — informed consent and cardiovascular risk assessment are mandatory. Abrocitinib (another JAK1-selective inhibitor) is an alternative.
Reference: NICE TA896 Upadacitinib AD; BAD