How does upadacitinib work in treating SSc-ILD?

Upadacitinib, a JAK inhibitor, works by blocking the activity of Janus kinases (JAKs), which are enzymes involved in inflammation and immune responses.By inhibiting these enzymes, upadacitinib can reduce inflammation and slow the progression of lung damage in SSc-ILD.

what were the main findings of the clinical trial on upadacitinib for SSc-ILD?

The clinical trial demonstrated that patients treated with upadacitinib experienced a reduced rate of decline in forced vital capacity (FVC) compared to those treated with mycophenolate mofetil,a standard treatment for SSc-ILD. This suggests that upadacitinib can effectively slow the progression of lung disease in these patients.

What are the current FDA-approved treatments for systemic sclerosis-associated interstitial lung disease?

Currently, nintedanib and tocilizumab are the only FDA-approved treatments for systemic sclerosis-associated interstitial lung disease (SSc-ILD). upadacitinib is not yet FDA-approved for this specific condition but is approved for other autoimmune diseases.

What are the potential risks associated with using JAK inhibitors like upadacitinib?

Potential risks associated with JAK inhibitors include an increased risk of infections, blood clots, and other adverse effects. Older patients may be more susceptible to these risks, requiring careful monitoring and consideration when prescribing upadacitinib.

Who sponsored the clinical trial on upadacitinib for SSc-ILD?

The clinical trial evaluating upadacitinib for the treatment of systemic sclerosis-associated interstitial lung disease was sponsored by Assiut University.

Systemic Sclerosis Increases Pregnancy Risks, Swedish Study Reveals

Stockholm, sweden – Women diagnosed with systemic sclerosis (SSc) face significantly elevated risks for adverse pregnancy outcomes, including preeclampsia adn preterm birth, according to a comprehensive Swedish cohort study. The findings underscore the critical need for enhanced maternal care and pre-pregnancy counseling for individuals with this autoimmune condition.

The population-based study, drawing on Swedish national health registers from 1987 to 2021, meticulously analyzed pregnancy outcomes in women with and without SSc. Researchers classified pregnancies based on thier timing relative to an SSc diagnosis, examining those occurring before and after the condition was identified.

The study identified 972 pregnancies in women with SSc, with 94 occurring after diagnosis and 878 before. These were carefully matched with comparator pregnancies in women without SSc.

key findings from the research indicate a heightened risk profile for pregnant women with SSc:

Post-diagnosis pregnancies were associated with substantially increased risks for preeclampsia (adjusted relative risk [aRR] 3.8), preterm birth (aRR 3.3), and cesarean delivery (aRR 2.5).
Primiparous women (those experiencing their first pregnancy) with SSc exhibited particularly alarming risks, with a 7.5-fold increase for preeclampsia and a 5.1-fold increase for preterm birth.
Pregnancies occurring within 0-3 years before an SSc diagnosis showed increased odds of preterm birth (adjusted odds ratio [aOR] 3.6) and delivering babies small for their gestational age (aOR 4.1).
Even pregnancies occurring more than 3 years prior to an SSc diagnosis were linked to increased odds of preeclampsia (aOR 1.9) and preterm birth (aOR 1.6).

“Our observations highlight the need for multidisciplinary maternal care and pre-pregnancy counseling also for today’s women with SSc, with a special focus on primiparous women for whom the risks are the highest,” the study’s authors stated.

The research,led by Weng lan Che,PhD,from the Clinical Epidemiology Division at Karolinska Institutet in Stockholm,was published online on July 8,2025,in Arthritis & Rheumatology.

While the study provides valuable insights,its limitations include a lack of detailed information on disease activity,specific serologic patterns,and treatment regimens.

The study received support from the Dr Margaretha Nilsson Foundation, the Swedish Research Council, and the Swedish Cancer Foundation. Disclosure statements from authors indicated affiliations with the Myositis Association and the Swedish Medical Products Agency.

This article was developed with the assistance of editorial tools, including AI, and underwent thorough review by human editors prior to publication.

Upadacitinib Shows Promise in Treating Systemic Sclerosis-Associated Interstitial Lung Disease

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Upadacitinib Shows Promise in Treating Systemic Sclerosis-Associated Interstitial Lung Disease

A recent clinical trial has revealed that the JAK inhibitor upadacitinib demonstrates effectiveness in treating systemic sclerosis-associated interstitial lung disease (SSc-ILD). The study, presented at the European Alliance of Associations for Rheumatology (EULAR) 2024 annual Meeting, indicates that upadacitinib reduces the rate of decline in forced vital capacity (FVC) in patients with SSc-ILD, compared to the current standard treatment, mycophenolate mofetil.

Upadacitinib Outperforms Standard Treatment in Lung Function preservation

The research, led by Dr. Manal Hassanien from Assiut University, Egypt, showed that after one year, the difference in the annual rate of decline in FVC between the upadacitinib and mycophenolate groups was 20.9 mL/year, favoring upadacitinib (P = .05).This suggests a meaningful benefit in preserving lung function for patients treated with upadacitinib.

Did You Know? Forced vital capacity (FVC) is the maximum amount of air a person can exhale after a maximum inhalation. It’s a key indicator of lung function.

The double-blinded, randomized study involved 57 patients with SSc, with disease onset of more than 3 years. All participants had an FVC less than 75% of the predicted normal value and evidence of lung fibrosis. Patients were administered either 15 mg of upadacitinib daily or 2000 mg of mycophenolate daily.

Detailed Study Results: FVC and DLCO Improvements

After 52 weeks, a decline of ≥ 5% in FVC from baseline was observed in 20.6% of the upadacitinib group, compared to 37.5% in the mycophenolate group. Furthermore,a 10% drop in FVC from baseline at 1 year was more common in patients taking mycophenolate (17.9%) than in those taking upadacitinib (6.8%).

Changes in diffusing capacity of the lungs for carbon monoxide (DLCO) at 52 weeks were also more favorable in the upadacitinib group (-62.7 mL) compared to the mycophenolate group (-93.3 mL). DLCO measures how well the lungs transfer gas from inhaled air to the bloodstream, providing another critical measure of lung health according to the american Thoracic Society.

Pro tip: Monitoring FVC and DLCO regularly can definitely help track the progression of SSc-ILD and assess the effectiveness of treatments.

Expert Commentary and Future Considerations

Dr. Iulia Szabo, a rheumatologist at “Iuliu Haţieganu” University of Medicine and Pharmacy, Romania, commented on the study, calling the results “really promising.” she noted that previous studies have shown encouraging evidence using other JAK inhibitors in SSc-ILD treatment, although the data were mostly experimental.

Szabo also cautioned that the younger age of participants in the study may mean that older patients could experience a higher risk of adverse events associated with JAK inhibitors.”The problem we might have will be with older patients as we certainly know all the adverse effects that JAK inhibitors have, and probably we should be a bit more cautious,” she said.

Current Treatment Landscape and Upadacitinib’s Potential Role

Currently, upadacitinib is FDA-approved for various conditions, including rheumatoid arthritis, psoriatic arthritis, and Crohn’s disease. However,for SSc-ILD,nintedanib and tocilizumab remain the only FDA-approved treatments. The findings from this study suggest that upadacitinib could potentially become another valuable option for managing this challenging condition.

Key metrics: Upadacitinib vs. Mycophenolate in SSc-ILD Treatment
Metric	Upadacitinib	Mycophenolate
Annual FVC decline Difference	Favored Upadacitinib (20.9 mL/year)	–
≥ 5% FVC Decline at 52 Weeks	20.6%	37.5%
10% FVC Drop at 1 Year	6.8%	17.9%
DLCO Change at 52 Weeks	-62.7 mL	-93.3 mL

What are your thoughts on the potential of upadacitinib for treating SSc-ILD?

How might these findings impact treatment strategies for patients with systemic sclerosis?

Evergreen Insights on Systemic Sclerosis-Associated Interstitial Lung Disease

Systemic sclerosis (SSc), also known as scleroderma, is a chronic autoimmune disease characterized by hardening and tightening of the skin and connective tissues. Interstitial lung disease (ILD) is a common and serious complication of SSc, affecting a significant proportion of patients. SSc-ILD can lead to progressive scarring of the lungs, resulting in shortness of breath, reduced exercise capacity, and ultimately, respiratory failure.

The management of SSc-ILD typically involves immunosuppressive medications aimed at reducing inflammation and slowing the progression of lung damage.however, current treatments have limitations, and new therapeutic options are needed to improve outcomes for patients with this debilitating condition. The emergence of JAK inhibitors like upadacitinib offers a promising avenue for future treatment strategies.

Frequently Asked Questions About Upadacitinib and SSc-ILD

Is upadacitinib a cure for systemic sclerosis-associated interstitial lung disease?: No, upadacitinib is not a cure for SSc-ILD. However, it may help to slow the progression of the disease and improve lung function.
How long does it take to see results with upadacitinib for SSc-ILD?: The clinical trial showed improvements in lung function within 52 weeks of treatment. Individual results may vary.
Are there any side effects associated with upadacitinib?: Yes,like all medications,upadacitinib can cause side effects. Common side effects may include infections, nausea, and headache. It is indeed critically important to discuss potential side effects with your healthcare provider.
Can upadacitinib be used in combination with other treatments for SSc-ILD?: The safety and efficacy of upadacitinib in combination with other treatments for SSc-ILD have not been fully established. Your healthcare provider can determine the best treatment approach for your individual situation.
Where can I find more information about systemic sclerosis-associated interstitial lung disease?: You can find more information about SSc-ILD from reputable sources such as the Scleroderma Foundation and the American Lung Association.

Disclaimer: This article provides information for general knowledge and awareness only. It does not constitute medical advice and should not be substituted for professional consultation with a qualified healthcare provider.

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Systemic Sclerosis and Pregnancy Risks: Increased Risks for Adverse Outcomes