Rinvoq Side effects: Upadacitinib – a JAK inhibitor

Rinvoq side effects are primarily related to the immune dysfunction caused by the drug. Thus, the most serious side effects of Rinvoq are related to infections and cancers which could arise as a result of long-term use of Rinvoq.

What is Rinvoq?

Rinvoq is the market name of Upadacitinib. It belongs to the class of drugs called JAK inhibitor (Janus Kinase).

JAK (Janus kinases) are molecules that transmit signals from various cytokines and chemicals to the end-organs, primarily the blood cells and the immune cells.

Hence, JAK inhibitors are used to treat autoimmune rheumatic diseases and blood disorders.

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What is Rinvoq used for?

Rinvoq (Upadacitinib) is indicated for the treatment of:

  • Active Rheumatoid Arthritis
  • Psoriatic Arthritis
  • Atopic Dermatitis

Rinvoq (Upadacitinib) is not a first-line medicine in the treatment of these conditions. However, patients with a poor response to first-line treatment and those who have not responded to at least one TNF inhibitor may be given a trial of Rinvoq.

To avoid Serious Side effects of Rinvoq, it should not be given in combination with other potent immune-suppressants such as DMARDs, Azathioprine, or Cyclosporin.

Rinvoq Side effects

The most important and serious side effects of Rinvoq are because of immune dysfunction or immune suppression caused by Rinvoq (Upadacitinib).

Serious infections may include fungal and mycobacterial infections. In addition, the reactivation of latent infections and herpes and varicella infections can also occur.

Following are the side effects it may cause :

  • Effect on the immune system

It may affect the body’s natural defense system by suppressing it and so many other diseases can occur as the body can not fight them with the same strength.

The most common infections related to Rinvoq (Upadacitinib) are skin infections (Cellulitis) and pneumonia [Ref].

Other infections may include opportunistic infections like mycobacterium tuberculosis, cryptococcal infections, and herpes infections.

With regard to Tuberculosis, it should be avoided in active TB infections. All patients should be tested for latent TB with an interferon-gamma release assay (IGRA). Those with a positive IGRA should be treated for latent TB.

In addition, patients already started on Rinvoq (Upadacitinib) should be monitored for new onset symptoms of Tuberculosis such as cough, phlegm, fever, and weight loss.

Before initiating treatment with Rinvoq, patients should also be screened for hepatitis B infections with Hepatitis B core IgM antibodies. Treatment should not be initiated in patients with active hepatitis B infection.

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  • Rinvoq and Cancers:

Rinvoq, like other JAK inhibitors, has been associated with lymphoproliferative disorders and skin cancers.

Importantly, the incidence of non-melanoma skin cancers is high in patients treated with JAK inhibitors.

Patients should be periodically examined for the occurrence of any new onset skin lesions. These lesions should be further investigated.

Lymphoproliferative disorders such as lymphoma can also occur in patients treated with Rinvoq. The treatment may be withheld in case of any suspicious lymph node is noted.

  • Rinvoq and clot formation:

Rinvoq (Upadacitinib) has been associated with thrombosis. Patients may develop DVT (deep vein thrombosis), Pulmonary embolism (PE), and arterial or venous thrombosis.

Older patients and patients at high risk of thrombosis should be watched for thrombotic events. Those with active thrombosis should not use Rinvoq (Upadacitinib).

  • Rinvoq and GI perforations:

Rinvoq (Upadacitinib) has been associated with GI perforations. In clinical trials, most patients were on concomitant NSAIDs.

Nevertheless, patients must be observed for any new onset gastrointestinal symptoms.

Other less serious side effects of Rinvoq (Upadacitinib) are summarized here:

  • Vomiting

It may cause nausea and vomiting as well as headache.

  • Dizziness

Dizziness and vertigo are common non-specific side effects of Rinvoq

  • Allergic symptoms

It may cause allergic symptoms such as cold, flu, cough, wheezing, etc

  • High temperature

It may also cause high temperature and body pains. A high temperature or fever can be secondary to an infection.

  • Inflammation

It may cause Inflammation of lips and face etc

  • Cardiac arrest

Cardiac arrest or angina may occur in patients taking it. Strokes and lumps in the blood may also happen.

Rinvoq (Upadacitinib) has been associated with an increased incidence of MACE (major adverse cardiovascular events).

  • Problems in respiration

Problems may occur in inhalation and exhalation of air.

  • Digestion issues

Diarrhea may occur which can lead to severe dehydration.

  • Problems in urinating

You may have to urinate more than normal and may feel difficulty while doing so.

  • Ulcers

Ulcers and holes may form in the digestive system such as in the stomach and intestine.

  • Anemia

Loss of Hb levels in the blood may occur leading to the yellowness of skin and pale color.

  • Change in weight

You may face drastic changes in your body weight, losing many pounds suddenly.

  • Fatigue

Your body may have abnormal and sudden pains and you may feel extremely exhausted like you have lifted heavy weights.

  • Perspiration

One may face abnormal sweating and the body may become deficient in salts.

  • Problem in speech

You may face difficulty in speaking and the other person in front may not easily understand what you are speaking as your words become mumbled or confusing.

  • Jaundice

The color of skin and eyes may change and turn a bit yellowish.

You may not feel an urge to eat something.

  • Referred pain

You may feel pain in different parts of the body such as jaws etc which originates from the chest.

  • Weakness

The one eating it may feel weakness in his/her body as if he or has not eaten in a while.

  • Faintness

You may feel faint some of the time.

  • Fluctuations in enzyme levels

It may cause changes in levels of enzymes such as those present in the liver.

  • Death

Death has also been reported in some patients and it may occur as a result of different complexities discussed above.

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