A ONCE-DAILY ORAL JAK inhibitor indicated for the treatment of adults and pediatric patients 12+ years of age with refractory, moderate to severe atopic dermatitis whose disease is not adequately controlled with other systemic drug products, including biologics, or when use of those therapies are inadvisable.1
WELL-STUDIED
SAFETY PROFILE
ACROSS 3 IMMUNE-MEDIATED DISEASES1
*Adults and pediatrics 12+.
†Based on prescription data with RINVOQ 15 mg in adults with moderate to severe rheumatoid arthritis as of August 2021.
Adverse Events of Special Interest
Adverse events (AEs) of special interest in all subjects through Week 16: integrated safety6
Adverse events (AEs) of special interest in all subjects: long-term integrated safety6,7
SAFETY CONSIDERATIONS
Serious Infections1: Patients treated with RINVOQ are at increased risk for developing infections that may lead to hospitalization or death. These infections include tuberculosis (TB) and invasive fungal, bacterial, viral, and other infections due to opportunistic pathogens. Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. If a serious infection develops, interrupt RINVOQ until the infection is controlled.
Carefully consider the risks and benefits of treatment with RINVOQ prior to initiating therapy in patients with chronic or recurrent infection. Monitor patients closely for the development of signs and symptoms of infection during and after treatment with RINVOQ, including the possible development of TB in patients who tested negative for latent TB infection prior to initiating therapy.
Mortality1: In a large, randomized, postmarketing safety study comparing another Janus kinase (JAK) inhibitor to tumor necrosis factor (TNF) blockers in rheumatoid arthritis (RA) patients ≥50 years old with at least one cardiovascular (CV) risk factor, a higher rate of all-cause mortality, including sudden cardiovascular death, was observed with the JAK inhibitor. Consider the benefits and risks for the individual patient prior to initiating or continuing therapy with RINVOQ.
Malignancies1: Lymphoma and other malignancies have been observed in patients treated with RINVOQ. In a large, randomized, postmarketing safety study comparing another JAK inhibitor with TNF blockers in RA patients, a higher rate of malignancies (excluding non-melanoma skin cancer [NMSC]), lymphomas, and lung cancer (in current or past smokers) was observed with the JAK inhibitor. Patients who are current or past smokers are at additional increased risk.
Consider the benefits and risks for the individual patient prior to initiating or continuing therapy, particularly in patients with a known malignancy (other than a successfully treated NMSC), patients who develop a malignancy when on treatment, and patients who are current or past smokers.
Non-melanoma skin cancers have been reported in patients treated with RINVOQ. Periodic skin examination is recommended for patients who are at increased risk for skin cancer. Advise patients to limit sunlight exposure by wearing protective clothing and using sunscreen.
Major Adverse Cardiovascular Events1: In a large, randomized, postmarketing study comparing another JAK inhibitor with TNF blockers in RA patients ≥50 years old with at least one CV risk factor, a higher rate of major adverse cardiovascular events (MACE) (defined as cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke), was observed with the JAK inhibitor. Patients who are current or past smokers are at additional increased risk. Discontinue RINVOQ in patients that have experienced a myocardial infarction or stroke.
Consider the benefits and risks for the individual patient prior to initiating or continuing therapy with RINVOQ, particularly in patients who are current or past smokers and patients with other cardiovascular risk factors. Patients should be informed about the symptoms of serious cardiovascular events and the steps to take if they occur.
Thrombosis1: Thrombosis, including deep venous thrombosis, pulmonary embolism, and arterial thrombosis have occurred in patients treated with JAK inhibitors used to treat inflammatory conditions. Many of these adverse events were serious and some resulted in death.
In a large, randomized, postmarketing study comparing another JAK inhibitor to TNF blockers in RA patients ≥50 years old with at least one CV risk factor, a higher rate of thrombosis was observed with the JAK inhibitor. Avoid RINVOQ in patients at risk. Patients with symptoms of thrombosis should discontinue RINVOQ and be promptly evaluated.
Gastrointestinal Perforations1: Gastrointestinal perforations have been reported in clinical trials with RINVOQ. Monitor RINVOQ-treated patients who may be at risk for gastrointestinal perforation (eg, patients with a history of diverticulitis or taking NSAIDs). Promptly evaluate patients presenting with new onset abdominal pain for early identification of gastrointestinal perforation.
Vaccination1: Avoid use of live vaccines during, or immediately prior to, RINVOQ therapy. Prior to initiating RINVOQ, patients should be brought up to date with all immunizations, including prophylactic zoster vaccinations, in agreement with current immunization guidelines.
Adverse reaction rates observed in clinical trials and LTE studies may not predict the rates observed in a broader patient population in clinical practice.
The adverse reaction profile in the pediatric patients was similar to the adults.1
aLong-term: safety data through November 24, 2020 (64-66% of patients had >1 year of exposure to RINVOQ; total exposure=2,788 patient years).7
bAll events were eczema herpeticum.
cPer protocol, patients experiencing AEs of malignancy (except for localized NMSC or cancer of the cervix in situ) and adjudicated VTE were required to discontinue therapy.
MACE=major adverse cardiovascular event; n/100 PY=number of subjects with at least 1 event per 100 PY; NMSC=non-melanoma skin cancer; PY=patient years; TB=tuberculosis; VTE=venous thromboembolism.
AEs of Special Interest: AEs with an onset date that is on or after the first dose of study drug and no more than 30 days after the last dose of upadacitinib and placebo.
MACE defined as cardiovascular death, non-fatal myocardial infarction and non-fatal stroke.
aLong-term: safety data through November 24, 2020 (64-66% of patients had >1 year of exposure to RINVOQ; total exposure=2,788 patient years).
bAll events were eczema herpeticum.
dAll but 1 event (esophageal candidiasis-RINVOQ 30 mg) were eczema herpeticum.
eRates shown are n/100 PY=number of subjects with at least 1 event per 100 PY. Per protocol, patients experiencing AEs of malignancy (except for localized NMSC or cancer of the cervix in situ) and adjudicated VTE were required to discontinue therapy.
E/100 PY=number of subjects with at least 1 event per 100 patient years; MACE=major adverse cardiovascular event; n/100 PY=number of subjects with at least 1 event per 100 PY; NMSC=non-melanoma skin cancer; PY=patient years; TB=tuberculosis; VTE=venous thromboembolism.
AEs of Special Interest: AEs with an onset date that is on or after the first dose of study drug and no more than 30 days after the last dose of upadacitinib and placebo.
MACE defined as cardiovascular death, non-fatal myocardial infarction and non-fatal stroke.
SAFETY CONSIDERATIONS
Serious Infections1: Patients treated with RINVOQ are at increased risk for developing infections that may lead to hospitalization or death. These infections include tuberculosis (TB) and invasive fungal, bacterial, viral, and other infections due to opportunistic pathogens. Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. If a serious infection develops, interrupt RINVOQ until the infection is controlled.
Carefully consider the risks and benefits of treatment with RINVOQ prior to initiating therapy in patients with chronic or recurrent infection. Monitor patients closely for the development of signs and symptoms of infection during and after treatment with RINVOQ, including the possible development of TB in patients who tested negative for latent TB infection prior to initiating therapy.
Mortality1: In a large, randomized, postmarketing safety study comparing another Janus kinase (JAK) inhibitor to tumor necrosis factor (TNF) blockers in rheumatoid arthritis (RA) patients ≥50 years old with at least one cardiovascular (CV) risk factor, a higher rate of all-cause mortality, including sudden cardiovascular death, was observed with the JAK inhibitor. Consider the benefits and risks for the individual patient prior to initiating or continuing therapy with RINVOQ.
Malignancies1: Lymphoma and other malignancies have been observed in patients treated with RINVOQ. In a large, randomized, postmarketing safety study comparing another JAK inhibitor with TNF blockers in RA patients, a higher rate of malignancies (excluding non-melanoma skin cancer [NMSC]), lymphomas, and lung cancer (in current or past smokers) was observed with the JAK inhibitor. Patients who are current or past smokers are at additional increased risk.
Consider the benefits and risks for the individual patient prior to initiating or continuing therapy, particularly in patients with a known malignancy (other than a successfully treated NMSC), patients who develop a malignancy when on treatment, and patients who are current or past smokers.
Non-melanoma skin cancers have been reported in patients treated with RINVOQ. Periodic skin examination is recommended for patients who are at increased risk for skin cancer. Advise patients to limit sunlight exposure by wearing protective clothing and using sunscreen.
Major Adverse Cardiovascular Events1: In a large, randomized, postmarketing study comparing another JAK inhibitor with TNF blockers in RA patients ≥50 years old with at least one CV risk factor, a higher rate of major adverse cardiovascular events (MACE) (defined as cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke), was observed with the JAK inhibitor. Patients who are current or past smokers are at additional increased risk. Discontinue RINVOQ in patients that have experienced a myocardial infarction or stroke.
Consider the benefits and risks for the individual patient prior to initiating or continuing therapy with RINVOQ, particularly in patients who are current or past smokers and patients with other cardiovascular risk factors. Patients should be informed about the symptoms of serious cardiovascular events and the steps to take if they occur.
Thrombosis1: Thrombosis, including deep venous thrombosis, pulmonary embolism, and arterial thrombosis have occurred in patients treated with JAK inhibitors used to treat inflammatory conditions. Many of these adverse events were serious and some resulted in death.
In a large, randomized, postmarketing study comparing another JAK inhibitor to TNF blockers in RA patients ≥50 years old with at least one CV risk factor, a higher rate of thrombosis was observed with the JAK inhibitor. Avoid RINVOQ in patients at risk. Patients with symptoms of thrombosis should discontinue RINVOQ and be promptly evaluated.
Gastrointestinal Perforations1: Gastrointestinal perforations have been reported in clinical trials with RINVOQ. Monitor RINVOQ-treated patients who may be at risk for gastrointestinal perforation (eg, patients with a history of diverticulitis or taking NSAIDs). Promptly evaluate patients presenting with new onset abdominal pain for early identification of gastrointestinal perforation.
Vaccination1: Avoid use of live vaccines during, or immediately prior to, RINVOQ therapy. Prior to initiating RINVOQ, patients should be brought up to date with all immunizations, including prophylactic zoster vaccinations, in agreement with current immunization guidelines.
Adverse events of special interest in pediatrics 12+: long-term integrated safety6,7
SAFETY CONSIDERATIONS
Serious Infections1: Patients treated with RINVOQ are at increased risk for developing infections that may lead to hospitalization or death. These infections include tuberculosis (TB) and invasive fungal, bacterial, viral, and other infections due to opportunistic pathogens. Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. If a serious infection develops, interrupt RINVOQ until the infection is controlled.
Carefully consider the risks and benefits of treatment with RINVOQ prior to initiating therapy in patients with chronic or recurrent infection. Monitor patients closely for the development of signs and symptoms of infection during and after treatment with RINVOQ, including the possible development of TB in patients who tested negative for latent TB infection prior to initiating therapy.
Mortality1: In a large, randomized, postmarketing safety study comparing another Janus kinase (JAK) inhibitor to tumor necrosis factor (TNF) blockers in rheumatoid arthritis (RA) patients ≥50 years old with at least one cardiovascular (CV) risk factor, a higher rate of all-cause mortality, including sudden cardiovascular death, was observed with the JAK inhibitor. Consider the benefits and risks for the individual patient prior to initiating or continuing therapy with RINVOQ.
Malignancies1: Lymphoma and other malignancies have been observed in patients treated with RINVOQ. In a large, randomized, postmarketing safety study comparing another JAK inhibitor with TNF blockers in RA patients, a higher rate of malignancies (excluding non-melanoma skin cancer [NMSC]), lymphomas, and lung cancer (in current or past smokers) was observed with the JAK inhibitor. Patients who are current or past smokers are at additional increased risk.
Consider the benefits and risks for the individual patient prior to initiating or continuing therapy, particularly in patients with a known malignancy (other than a successfully treated NMSC), patients who develop a malignancy when on treatment, and patients who are current or past smokers.
Non-melanoma skin cancers have been reported in patients treated with RINVOQ. Periodic skin examination is recommended for patients who are at increased risk for skin cancer. Advise patients to limit sunlight exposure by wearing protective clothing and using sunscreen.
Major Adverse Cardiovascular Events1: In a large, randomized, postmarketing study comparing another JAK inhibitor with TNF blockers in RA patients ≥50 years old with at least one CV risk factor, a higher rate of major adverse cardiovascular events (MACE) (defined as cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke), was observed with the JAK inhibitor. Patients who are current or past smokers are at additional increased risk. Discontinue RINVOQ in patients that have experienced a myocardial infarction or stroke.
Consider the benefits and risks for the individual patient prior to initiating or continuing therapy with RINVOQ, particularly in patients who are current or past smokers and patients with other cardiovascular risk factors. Patients should be informed about the symptoms of serious cardiovascular events and the steps to take if they occur.
Thrombosis1: Thrombosis, including deep venous thrombosis, pulmonary embolism, and arterial thrombosis have occurred in patients treated with JAK inhibitors used to treat inflammatory conditions. Many of these adverse events were serious and some resulted in death.
In a large, randomized, postmarketing study comparing another JAK inhibitor to TNF blockers in RA patients ≥50 years old with at least one CV risk factor, a higher rate of thrombosis was observed with the JAK inhibitor. Avoid RINVOQ in patients at risk. Patients with symptoms of thrombosis should discontinue RINVOQ and be promptly evaluated.
Gastrointestinal Perforations1: Gastrointestinal perforations have been reported in clinical trials with RINVOQ. Monitor RINVOQ-treated patients who may be at risk for gastrointestinal perforation (eg, patients with a history of diverticulitis or taking NSAIDs). Promptly evaluate patients presenting with new onset abdominal pain for early identification of gastrointestinal perforation.
Vaccination1: Avoid use of live vaccines during, or immediately prior to, RINVOQ therapy. Prior to initiating RINVOQ, patients should be brought up to date with all immunizations, including prophylactic zoster vaccinations, in agreement with current immunization guidelines.
Adverse reaction rates observed in clinical trials and LTE studies may not predict the rates observed in a broader patient population in clinical practice.
The adverse reaction profile in the pediatric patients was similar to the adults.1
eRates shown are n/100 PY=number of subjects with at least 1 event per 100 PY. Per protocol, patients experiencing AEs of malignancy (except for localized NMSC or cancer of the cervix in situ) and adjudicated VTE were required to discontinue therapy.
E/100 PY=number of subjects with at least 1 event per 100 patient years; MACE=major adverse cardiovascular event; n/100 PY=number of subjects with at least 1 event per 100 PY; NMSC=non-melanoma skin cancer; PY=patient years; TB=tuberculosis; VTE=venous thromboembolism.
MACE defined as cardiovascular death, non-fatal myocardial infarction and non-fatal stroke.
eRates shown are n/100 PY=number of subjects with at least 1 event per 100 PY. Per protocol, patients experiencing AEs of malignancy (except for localized NMSC or cancer of the cervix in situ) and adjudicated VTE were required to discontinue therapy.
E/100 PY=number of subjects with at least one event per 100 patient years; MACE=major adverse cardiovascular event; n/100 PY=number of subjects with at least 1 event per 100 PY; NMSC=non-melanoma skin cancer; PY=patient years; TB=tuberculosis; VTE=venous thromboembolism.
MACE defined as cardiovascular death, non-fatal myocardial infarction and non-fatal stroke.
SAFETY CONSIDERATIONS
Serious Infections1: Patients treated with RINVOQ are at increased risk for developing infections that may lead to hospitalization or death. These infections include tuberculosis (TB) and invasive fungal, bacterial, viral, and other infections due to opportunistic pathogens. Most patients who developed these infections were taking concomitant immunosuppressants such as methotrexate or corticosteroids. If a serious infection develops, interrupt RINVOQ until the infection is controlled.
Carefully consider the risks and benefits of treatment with RINVOQ prior to initiating therapy in patients with chronic or recurrent infection. Monitor patients closely for the development of signs and symptoms of infection during and after treatment with RINVOQ, including the possible development of TB in patients who tested negative for latent TB infection prior to initiating therapy.
Mortality1: In a large, randomized, postmarketing safety study comparing another Janus kinase (JAK) inhibitor to tumor necrosis factor (TNF) blockers in rheumatoid arthritis (RA) patients ≥50 years old with at least one cardiovascular (CV) risk factor, a higher rate of all-cause mortality, including sudden cardiovascular death, was observed with the JAK inhibitor. Consider the benefits and risks for the individual patient prior to initiating or continuing therapy with RINVOQ.
Malignancies1: Lymphoma and other malignancies have been observed in patients treated with RINVOQ. In a large, randomized, postmarketing safety study comparing another JAK inhibitor with TNF blockers in RA patients, a higher rate of malignancies (excluding non-melanoma skin cancer [NMSC]), lymphomas, and lung cancer (in current or past smokers) was observed with the JAK inhibitor. Patients who are current or past smokers are at additional increased risk.
Consider the benefits and risks for the individual patient prior to initiating or continuing therapy, particularly in patients with a known malignancy (other than a successfully treated NMSC), patients who develop a malignancy when on treatment, and patients who are current or past smokers.
Non-melanoma skin cancers have been reported in patients treated with RINVOQ. Periodic skin examination is recommended for patients who are at increased risk for skin cancer. Advise patients to limit sunlight exposure by wearing protective clothing and using sunscreen.
Major Adverse Cardiovascular Events1: In a large, randomized, postmarketing study comparing another JAK inhibitor with TNF blockers in RA patients ≥50 years old with at least one CV risk factor, a higher rate of major adverse cardiovascular events (MACE) (defined as cardiovascular death, non-fatal myocardial infarction, and non-fatal stroke), was observed with the JAK inhibitor. Patients who are current or past smokers are at additional increased risk. Discontinue RINVOQ in patients that have experienced a myocardial infarction or stroke.
Consider the benefits and risks for the individual patient prior to initiating or continuing therapy with RINVOQ, particularly in patients who are current or past smokers and patients with other cardiovascular risk factors. Patients should be informed about the symptoms of serious cardiovascular events and the steps to take if they occur.
Thrombosis1: Thrombosis, including deep venous thrombosis, pulmonary embolism, and arterial thrombosis have occurred in patients treated with JAK inhibitors used to treat inflammatory conditions. Many of these adverse events were serious and some resulted in death.
In a large, randomized, postmarketing study comparing another JAK inhibitor to TNF blockers in RA patients ≥50 years old with at least one CV risk factor, a higher rate of thrombosis was observed with the JAK inhibitor. Avoid RINVOQ in patients at risk. Patients with symptoms of thrombosis should discontinue RINVOQ and be promptly evaluated.
Gastrointestinal Perforations1: Gastrointestinal perforations have been reported in clinical trials with RINVOQ. Monitor RINVOQ-treated patients who may be at risk for gastrointestinal perforation (eg, patients with a history of diverticulitis or taking NSAIDs). Promptly evaluate patients presenting with new onset abdominal pain for early identification of gastrointestinal perforation.
Vaccination1: Avoid use of live vaccines during, or immediately prior to, RINVOQ therapy. Prior to initiating RINVOQ, patients should be brought up to date with all immunizations, including prophylactic zoster vaccinations, in agreement with current immunization guidelines.
STUDY DESIGNS
Measure Up
MEASURE UP 1 (N=847) and MEASURE UP 2 (N=836) were phase 3, multicenter, randomized, double-blind, parallel-group, placebo-controlled studies to evaluate the efficacy and safety of RINVOQ (15 mg or 30 mg) vs placebo over 16 weeks in adult and pediatric (≥12 years of age) patients with moderate to severe atopic dermatitis. Adult patients who completed the original 16-week double-blind MEASURE UP studies were eligible for blinded, extended treatment for at least 52 weeks.1,8
AD Up
AD UP (N=901) was a phase 3, multicenter, randomized, double-blind, parallel-group, placebo-controlled study to evaluate the efficacy and safety of RINVOQ (15 mg or 30 mg) + TCS vs placebo + TCS over 16 weeks in adult and pediatric (≥12 years of age) patients with moderate to severe atopic dermatitis. Patients who completed the original 16-week double-blind AD UP study were eligible for blinded, extended treatment for at least 52 weeks.9
A closer look at
AEs of special interest
Data as of November 24, 20206,7
Integrated data from MEASURE UP 1, 2, and AD UP
RINVOQ 15 mg: n=1,239; PY=1,373.4
RINVOQ 30 mg: n=1,246; PY=1,414.2
Placebo (integrated data at Week 16, includes Phase 2b): n=902; PY=255.0
Adverse reaction rates observed in clinical trials and LTE studies may not predict the rates observed in clinical practice.
AEs of special interest in AD and RA:
long-term integrated safety4,7,10
Data from 9 clinical trials
and their long-term
extension studies
(AD, 3; RA, 6)
AD data as of November 24, 2020; RA data as of June 30, 2020
Overall, the safety profile observed in patients with AD treated with RINVOQ was similar to the safety profile in patients with RA.1
Adverse reaction rates observed in clinical trials and LTE studies may not predict the rates observed in a broader patient population in clinical practice.
RA STUDIES: RINVOQ was studied in RA patients across 6 trials that included RINVOQ monotherapy and combination therapy with csDMARDs. RA long-term data comprises a maximum exposure of ~4.5 years and a median exposure of 2.6 years.4
eRates shown are n/100 PY=number of subjects with at least 1 event per 100 PY. Per protocol, patients experiencing AEs of malignancy (except for localized NMSC or cancer of the cervix in situ) and adjudicated VTE and MACE were required to discontinue therapy.
fAD long-term: safety data through November 24, 2020 (64-66% of patients had >1 year of exposure to RINVOQ; total exposure=2,788 patient years).
gAll but 1 event (esophageal candidiasis, RINVOQ 30 mg) were eczema herpeticum.
hOpportunistic infection (excluding TB, herpes zoster, and oral candidiasis).
AEs=adverse events; AD=atopic dermatitis; csDMARDs=conventional synthetic disease-modifying antirheumatic drugs; E/100 PY=number of subjects with at least 1 event per 100 patient years; GI=gastrointestinal tract; LTE=long-term extension; MACE=major adverse cardiovascular event; n/100 PY=number of subjects with at least 1 event per 100 PY; NMSC=non-melanoma skin cancer; PY=patient years; RA=rheumatoid arthritis; TB=tuberculosis; VTE=venous thromboembolic event.
MACE defined as cardiovascular death, non-fatal myocardial infection and non-fatal stroke.
Common adverse events
Most common adverse events ≥1% in all subjects through Week 16: integrated safety1
Adverse reaction rates observed in clinical trials and LTE studies may not predict the rates observed in a broader patient population in clinical practice.
iIncludes: laryngitis, laryngitis viral, nasopharyngitis, oropharyngeal pain, pharyngeal abscess, pharyngitis, pharyngitis streptococcal, pharyngotonsillitis, respiratory tract infection, respiratory tract infection viral, rhinitis, rhinolaryngitis, sinusitis, tonsillitis, tonsillitis bacterial, upper respiratory tract infection, viral pharyngitis, viral upper respiratory tract infection.
jIncludes: acne and dermatitis acneiform.
kIncludes: genital herpes, genital herpes simplex, herpes dermatitis, herpes ophthalmic, herpes simplex, nasal herpes, ophthalmic herpes simplex, herpes virus infection, oral herpes.
lIncludes anaphylactic reaction, anaphylactic shock, angioedema, dermatitis exfoliative generalized, drug hypersensitivity, eyelid oedema, face oedema, hypersensitivity, periorbital swelling, pharyngeal swelling, swelling face, toxic skin eruption, type I hypersensitivity, urticaria.
mIncludes abdominal pain and abdominal pain upper.
nIncludes herpes zoster and varicella.
ADDITIONAL ACNE CONSIDERATIONS6
Through Week 16 in all subjects, acne events occurred in 10% and 16% of patients in the RINVOQ 15 mg group (n=899) and RINVOQ 30 mg group (n=906), respectively, compared with 2% in the placebo group (n=902).
Monitoring and treatment considerations
Perform lab testing for 1:
oAccording to guidelines for hyperlipidemia.
Interrupt treatment if patient develops a serious or opportunistic infection1
Treatment may be restarted when blood levels return to acceptable values seen in chart above, drug-induced liver diagnosis is excluded or infection is controlled.1
RINVOQ is not recommended for use in patients with severe hepatic impairment.1
Discontinue RINVOQ in patients that have experienced a myocardial infarction or stroke.1
Avoid RINVOQ in patients that may be at increased risk of thrombosis.1
Screen and periodically monitor for:
- SERIOUS INFECTIONS1
Closely monitor patients for the development of signs and symptoms of infection during and after treatment with RINVOQ.
- TUBERCULOSIS1
Monitor patients for the development of signs and symptoms of TB, including patients who tested negative for latent TB infection prior to initiating therapy.
- VIRAL REACTIVATION1
Screening for viral hepatitis and monitoring for reactivation should be performed in accordance with clinical guidelines before starting and during therapy with RINVOQ.
- PREGNANCY1
Based on animal studies, RINVOQ may cause embryo-fetal toxicity when administered to pregnant women. Verify pregnancy status prior to starting treatment. Advise women to use effective contraception during and for 4 weeks after completion of treatment.
Interrupt treatment if patient develops a serious or opportunistic infection1
Treatment may be restarted when blood levels return to acceptable values seen in chart above, drug-induced liver diagnosis is excluded or infection is controlled.1
RINVOQ is not recommended for use in patients with severe hepatic impairment.1
Discontinue RINVOQ in patients that have experienced a myocardial infarction or stroke.1
Avoid RINVOQ in patients that may be at increased risk of thrombosis.1
Lab abnormalities: placebo-controlled period through 16 weeks1,6
Lipid elevations: Treatment with RINVOQ was associated with increases in lipid parameters, including total cholesterol, LDL cholesterol, and HDL cholesterol.
pIncludes subjects from M16-048, MEASURE UP 1, MEASURE UP 2, and AD UP.
ALT=alanine aminotransferase; AST=aspartate transaminase; CPK=creatine phosphokinase; HDL=high-density lipoprotein; LDL=low-density lipoprotein; ULN=upper limit of normal.
For adults <65 years and pediatric patients 12+ years weighing at least 40 kg (88 lb), initiate treatment with RINVOQ 15 mg once-daily in pediatric patients (≥12 years, ≥40 kg) and adults <65 years of age. If an adequate response is not achieved, consider increasing the dosage to 30 mg once-daily. Discontinue RINVOQ if an adequate response is not achieved with the 30 mg dose. Use the lowest effective dose needed to maintain response. For patients ≥65 years, patients receiving strong CYP3A4 inhibitors, and patients with severe renal impairment, the recommended dose of RINVOQ is 15 mg once-daily.1
