Off-label use of upadacitinib in dermatology: a review.

OBJECTIVES

Upadacitinib, a selective JAK1 inhibitor, is approved for the treatment of atopic dermatitis but is increasingly used off-label in dermatology. This study aimed to summarize the existing evidence on such off-label use to clarify its potential value and safety in dermatological practice.

METHODS

We identified 113 papers (n = 638) on the off-label use of upadacitinib for dermatological conditions via PubMed.

RESULTS

Our findings indicate that upadacitinib demonstrated potential efficacy in alopecia areata, vitiligo, lupus erythematosus, and other dermatoses. The most common upadacitinib dose is 15 mg/day. Common adverse events included elevated creatine kinase levels, infections, and acne.

CONCLUSIONS

While preliminary data show promising results, the evidence is limited to case reports and case series. Future randomized trials are needed to validate efficacy and safety.