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NewsA small UK feasibility trial found that upadacitinib (Rinvoq), a JAK inhibitor, dramatically reduced disease severity in patients with palmoplantar pustulosis (PPP) — a stubborn, painful skin condition affecting the hands and feet. Compared to a historic placebo group, upadacitinib slashed average disease scores from 20.3 to 4.6 in just 8 weeks. Researchers say the results are promising enough to justify a full-scale definitive trial.
Palmoplantar pustulosis (PPP) is a chronic, difficult-to-treat skin condition causing painful pustules on the palms and soles — and effective therapies have been hard to come by. Now, a UK feasibility trial called JAKPPPOT is offering a glimmer of hope, showing that the JAK inhibitor upadacitinib (Rinvoq) may meaningfully reduce disease severity in this patient population.
The open-label study enrolled 20 adults with moderate-to-severe PPP, treating them with upadacitinib 30 mg once daily for 8 weeks. Results were compared against a historic placebo cohort from the earlier APRICOT trial. All prespecified feasibility benchmarks were met — 95% of participants adhered to their treatment, and nearly 95% found it acceptable.
By the Numbers:
Why it matters: PPP has very few proven treatment options, leaving many patients with limited relief. While this trial wasn't powered to confirm efficacy, the magnitude of improvement seen here is striking — and researchers are now calling for a larger, definitive trial with an active comparator arm to validate these findings.