Upadacitinib as a treatment for chronic pruritus secondary to polycythemia vera after failure with dupilumab

Aquagenic pruritus successfully treated with upadacitinib

“…A case of a patient with polycythaemia rubra vera and chronic pruritus, not associated with water exposure, effectively treated with upadacitinib has recently been published. 7 The efficacy of upadacitinib in the treatment of pruritus in two disorders without apparent primary cutaneous involvement, where inflammation presumably does not play a pathogenic role, as well as the rapid improvement in AD, which precedes cutaneous improvement, 8 supports the role of the JAK1 pathway in the pathophysiology of chronic pruritus. This observation is supported by the observation that JAK1 is enriched in pruriceptive neurons, as well as by the fact that both pharmacological inhibition of JAK1 and genetic deletion of JAK1 in mice resulted in abatement of chronic itch.…”