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. 2023 May;40(5):2509-2514.
doi: 10.1007/s12325-023-02490-5. Epub 2023 Mar 21.

Real-Life Effectiveness and Tolerance of Upadacitinib for Severe Atopic Dermatitis in Adolescents and Adults

Axel De Greef  1 , Pierre-Dominique Ghislain  2 , Laurence de Montjoye  2 , Marie Baeck  2
Affiliations

Real-Life Effectiveness and Tolerance of Upadacitinib for Severe Atopic Dermatitis in Adolescents and Adults

Axel De Greef et al. Adv Ther. 2023 May.

Abstract

Introduction: The efficacy and safety of upadacitinib in atopic dermatitis have been defined in clinical trials, but long-term real-life experience, essential for clinical decision-making, is still limited. We aimed to assess the effectiveness and tolerance of upadacitinib in a real-life cohort of adults and adolescents with severe atopic dermatitis in whom previous systemic therapies largely failed.

Methods: Retrospective cohort study collecting data from adults and adolescents treated with upadacitinib 15 or 30 mg per day between July 2021 to August 2022. The outcomes for effectiveness were evaluated by the percentage of patients who achieved a validated Investigator's Global Assessment for atopic dermatitis (vIGA-AD) of 0 (clear) or 1 (almost clear) and/or an improvement of at least 75% on the Eczema Area and Severity Index (EASI 75) at the end of the follow-up. All treatment-emergent adverse events were collected.

Results: A total of 29 patients were included (22 adults and 7 adolescents), with a median follow-up of 54.4 weeks. At the end of the follow-up, 23 patients (79.3%) reached a vIGA-AD of 0/1, and 24 patients (82.7%) achieved EASI 75. Among patients treated with upadacitinib after initial failure of first- and/or second-line treatment with biologics or baricitinib, 5/7 patients (71.4%) reached a vIGA-AD score of 0/1. Disease control was slightly better in adults than in adolescents (81.8% vs 71.4% reached the efficacy endpoint, respectively). Response rate in patients with upadacitinib 15 mg seemed better than in clinical trials or network meta-analysis. Safety data were reassuring; lipid changes were the most frequent adverse event.

Conclusion: This real-life study confirms the effectiveness of upadacitinib, particularly for the treatment of atopic dermatitis recalcitrant to conventional systemic agents, biologics or baricitinib. Induced lipid changes require close follow-up.

Keywords: Atopic dermatitis; Effectiveness; JAK inhibitor; Real-life study; Tolerance; Upadacitinib.

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Conflict of interest statement

Pierre-Dominique Ghislain discloses his past participation as an investigator and as a scientific advisor for AbbVie. Pierre-Dominique Ghislain and Marie Baeck have previously participated as speakers in events sponsored by AbbVie. None of the authors has scientific or financial conflicts of interests to declare in the current reported study.

Figures

Fig. 1
Fig. 1
Sankey diagram illustrating the sequence of systemic treatments for 22 adult patients with atopic dermatitis. The size of the box and width of the lines are proportional to the number of patients
See this image and copyright information in PMC

References

    1. McLornan DP, Pope JE, Gotlib J, Harrison CN. Current and future status of JAK inhibitors. Lancet. 2021;398(10302):803–816. doi: 10.1016/S0140-6736(21)00438-4. - DOI - PubMed
    1. Schneider S, Li L, Zink A. The new era of biologics in atopic dermatitis: a review. Dermatol Pract Concept. 2021;11(4):e2021144. doi: 10.5826/dpc.1104a144. - DOI - PMC - PubMed
    1. Guttman-Yassky E, Teixeira HD, Simpson EL, et al. Once-daily upadacitinib versus placebo in adolescents and adults with moderate-to-severe atopic dermatitis (Measure Up 1 and Measure Up 2): results from two replicate double-blind, randomised controlled phase 3 trials. Lancet. 2021;397(10290):2150. doi: 10.1016/S0140-6736(21)00588-2. - DOI - PubMed
    1. Reich K, Teixeira HD, de Bruin-Weller M, et al. Safety and efficacy of upadacitinib in combination with topical corticosteroids in adolescents and adults with moderate-to-severe atopic dermatitis (AD Up): results from a randomised, double-blind, placebo-controlled, phase 3 trial. Lancet. 2021;398(10302):746. doi: 10.1016/S0140-6736(21)00589-4. - DOI - PubMed
    1. Simpson EL, Papp KA, Blauvelt A, et al. Efficacy and safety of upadacitinib in patients with moderate to severe atopic dermatitis: analysis of follow-up data from the measure up 1 and measure up 2 randomized clinical trials. JAMA Dermatol. 2022;158(4):404–413. doi: 10.1001/jamadermatol.2022.0029. - DOI - PMC - PubMed

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