PMID- 37864486
OWN - NLM
STAT- MEDLINE
DCOM- 20240131
LR  - 20240131
IS  - 1468-3083 (Electronic)
IS  - 0926-9959 (Linking)
VI  - 38
IP  - 2
DP  - 2024 Feb
TI  - Upadacitinib treatment in a real-world difficult-to-treat atopic dermatitis 
      patient cohort.
PG  - 384-392
LID - 10.1111/jdv.19581 [doi]
AB  - BACKGROUND: Upadacitinib was the first JAK-1 selective inhibitor registered for 
      the treatment of moderate-to-severe atopic dermatitis (AD). Although efficacy and 
      safety have been shown in clinical trials, real-world data on the use of 
      upadacitinib in patients that have been treated with other immunosuppressants and 
      targeted therapies is limited. OBJECTIVES: To provide real-world evidence on the 
      use of upadacitinib treatment in moderate-to-severe atopic dermatitis. METHODS: 
      In this prospective observational single-centre study, all AD patients treated 
      with upadacitinib treatment in the context of standard care were included between 
      August 2021 and September 2022. Clinical outcome measures and adverse events 
      (AEs) were analysed. RESULTS: Forty-eight patients were included. The majority 
      (n = 39; 81%) had failed (ineffectiveness) on other targeted therapies, including 
      other JAK inhibitors and biologics. Thirty-four (71%) patients were still using 
      upadacitinib treatment at last follow up (median duration 46.5 weeks). Fourteen 
      (29%) patients discontinued treatment due to ineffectiveness or AE. Upadacitinib 
      treatment led to a significant decrease of disease severity during a median 
      follow up of 37.5 weeks. Median IGA at baseline decreased from 3 (IQR 2-3) to 1.5 
      (IQR 1-2) at last review (p < 0.001). Median NRS itch decreased from 7 (IQR 5-8) 
      at baseline to 2.25 (IQR 0.25-6.5) at last review (p < 0.001). Three patients 
      discontinued treatment due to AE. Forty-eight AEs were reported, including 
      acne-like eruptions (25%), nausea (13%) and respiratory tract infections (10%). 
      CONCLUSIONS: In this real-world cohort, we confirmed that upadacitinib is an 
      effective treatment in a subset of AD patients that have failed several previous 
      systemic immunosuppressive and biologic treatments. Overall, AE were mostly well 
      tolerated and not a reason to discontinue treatment for most patients.
CI  - (c) 2023 The Authors. Journal of the European Academy of Dermatology and 
      Venereology published by John Wiley & Sons Ltd on behalf of European Academy of 
      Dermatology and Venereology.
FAU - Schlosser, Anne R
AU  - Schlosser AR
AUID- ORCID: 0000-0003-0449-6077
AD  - Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the 
      Netherlands.
FAU - Boeijink, Neill
AU  - Boeijink N
AD  - Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the 
      Netherlands.
FAU - Olydam, Jill
AU  - Olydam J
AUID- ORCID: 0000-0002-7391-5266
AD  - Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the 
      Netherlands.
FAU - Nijsten, Tamar E C
AU  - Nijsten TEC
AUID- ORCID: 0000-0001-9940-2875
AD  - Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the 
      Netherlands.
FAU - Hijnen, DirkJan
AU  - Hijnen D
AUID- ORCID: 0000-0003-3379-3425
AD  - Department of Dermatology, Erasmus MC University Medical Center, Rotterdam, the 
      Netherlands.
LA  - eng
PT  - Journal Article
PT  - Observational Study
DEP - 20231116
PL  - England
TA  - J Eur Acad Dermatol Venereol
JT  - Journal of the European Academy of Dermatology and Venereology : JEADV
JID - 9216037
RN  - 0 (Heterocyclic Compounds, 3-Ring)
RN  - 0 (Immunosuppressive Agents)
RN  - 0 (Janus Kinase Inhibitors)
RN  - 4RA0KN46E0 (upadacitinib)
SB  - IM
MH  - Humans
MH  - *Acne Vulgaris
MH  - *Dermatitis, Atopic/drug therapy
MH  - Heterocyclic Compounds, 3-Ring/adverse effects
MH  - Immunosuppressive Agents/adverse effects
MH  - *Janus Kinase Inhibitors/adverse effects
MH  - Pruritus
MH  - Severity of Illness Index
MH  - Treatment Outcome
MH  - Prospective Studies
EDAT- 2023/10/21 19:43
MHDA- 2024/01/26 06:43
CRDT- 2023/10/21 06:45
PHST- 2023/06/30 00:00 [received]
PHST- 2023/09/29 00:00 [accepted]
PHST- 2024/01/26 06:43 [medline]
PHST- 2023/10/21 19:43 [pubmed]
PHST- 2023/10/21 06:45 [entrez]
AID - 10.1111/jdv.19581 [doi]
PST - ppublish
SO  - J Eur Acad Dermatol Venereol. 2024 Feb;38(2):384-392. doi: 10.1111/jdv.19581. 
      Epub 2023 Nov 16.