Practical Use of Upadacitinib in Patients with Severe Atopic Dermatitis in a Real-World Setting: A Systematic Review

Abstract

Upadacitinib is a selective Janus kinase inhibitor approved for the treatment of severe atopic dermatitis (AD). This systematic review aims to summarize the most recent data in terms of effectiveness and safety of upadacitinib in the treatment of severe AD in a real-world setting. The review included a comprehensive search of databases, including PubMed, Google Scholar and Web of Science, according to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The literature search initially identified 242 studies. Of these, 214 were excluded after reviewing their titles and abstracts. We then conducted a full-text review of 25 studies, of which 17 met our inclusion criteria and were therefore included in our systematic review. The analysis of real-world studies showed high effectiveness of upadacitinib, in terms of both clinical signs and subjective symptoms, in different patient populations, including those resistant to other treatments. No new significant safety concerns have emerged as compared to randomized clinical trials.

Sustained Effectiveness of Upadacitinib in Moderate-to-Severe Atopic Dermatitis: A 48-Week Real-World Study

“…The effectiveness of upadacitinib was robust, regardless of previous dupilumab exposure, and the study reported no serious AEs. Ibba L et al's systematic review further confirms the long-term effectiveness and safety of upadacitinib for severe AD in real-world studies [17]. Through these comparative analyses, the vital role of upadacitinib in the AD treatment landscape is reinforced, endorsing its application as a primary treatment option for achieving long-term disease control.…”

“…Reports on the long-term effectiveness and safety of upadacitinib in managing AD in real-world clinical studies are increasing, illustrating the sustained therapeutic potential of the drug. This is highlighted in studies from Italy, such as those by Chiricozzi A et al 2023 andGargiulo et al 2023, as well as the systematic review by Ibba L et al [17] and others [8,10,[18][19][20]. Chiricozzi A et al detailed the outcomes for 146 patients with moderateto-severe AD, most of whom (87.0%) received upadacitinib as monotherapy [8].…”