A 96-week real-world outcome of upadacitinib treatment for atopic dermatitis: Systemic therapy-naive versus -experienced patients

Abstract

Background: Long-term (2 years) effectiveness of upadacitinib for atopic dermatitis (AD) is unknown in real-world practice.

Objective: To evaluate 96-week real-world effectiveness of upadacitinib in Japanese patients with moderate-to-severe AD, stratified by the presence or absence of prior systemic therapies.

Methods: This prospective study included 327 Japanese patients treated with upadacitinib 15 mg (n = 248) or 30 mg (n = 79). Clinical and laboratory indexes were assessed until week 96 in systemic therapy-naive and -experienced patients.

Results: Upadacitinib 15 and 30 mg reduced eczema area and severity index, atopic dermatitis control tool, and peak pruritus numerical rating scale at week 4, and these reductions were mostly maintained until week 96. The clinical scores slightly increased at time points later than week 36 in systemic-therapy-experienced patients treated with 15 mg. Total eosinophil count sharply decreased at week 4 or 12 and plateaued thereafter except for the increase at time points later than week 36 in systemic therapy-experienced patients treated with 15 mg.

Limitations: Single-center and Japanese-limited cohort.

Conclusions: Upadacitinib demonstrated mostly sustained effectiveness for AD throughout a 96-week period in real-world practice with slightly reduced effectiveness at time points later than week 36 in systemic therapy-experienced patients treated with 15 mg upadacitinib.

Keywords: Janus kinase inhibitor; atopic dermatitis; biomarker; systemic therapy; upadacitinib.