Real‐life experience of upadacitinib for the treatment of adult patients with moderate‐to‐severe atopic dermatitis – a case series

Feraru, Guy; Nevet, Mariela Judith; Samuelov, Liat; E, Hodak; Avitan‐Hersh, Emily; Ziv, Michael; Dodiuk‐Gad, Roni P.

doi:10.1111/jdv.18311

Cited by 14 publications

(9 citation statements)

References 4 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Compared with other real-life studies, we found similar responses in terms of IGA [ 18 ] and EASI75 [ 19 ]. Regarding another real-life experience from Hagino et al .…”

Section: Discussionsupporting

confidence: 79%

Real-Life Effectiveness and Safety of Upadacitinib in Adults and Adolescents with Moderate-to-Severe Atopic Dermatitis: A Single-Center 16-Week Study

Gargiulo

Ibba

Cortese

et al. 2023

Dermatol Ther (Heidelb)

View full text Add to dashboard Cite

Introduction The treatment of severe atopic dermatitis (AD) includes cyclosporine and recently approved biologics and small molecules. Among these, upadacitinib is a selective inhibitor of Janus kinase 1, approved for the treatment of severe AD in adolescents/adults. Upadacitinib has shown efficacy and safety in several phase 3 clinical trials, but data on real-life patients are still lacking. Methods We conducted a retrospective real-life observational study to evaluate the effectiveness and safety of upadacitinib up to week 16 in a cohort of both bio-naïve and bio-experienced patients. This study was carried out by analyzing the AD database records of an Italian referral hospital. Thirty-eight patients were included in this study, and 35 completed 16 weeks of treatment. Results At week 16, out of 35 patients, the percentages of Eczema Area and Severity Index (EASI) 50, EASI 75, EASI 90 and EASI 100 responses were 94.29, 91.43, 74.29, and 60%, respectively. A decrease of at least 4 points from baseline of itch-NRS was reported by 94.74 and 91.43% of patients at weeks 8 and 16. Regarding the safety of upadacitinib, 26.32% of patients experienced at least one adverse event (AE), and a total of 13 AEs were recorded, including blood test abnormalities and papulopustular acne. None of our patients interrupted the drug because of an AE. Conclusions We observed higher rates of EASI75/EASI90/EASI100 responses at week 16, compared with data from clinical trials. The safety profile of upadacitinib was favorable, as no AEs leading to discontinuation were experienced by our patients up to week 16.

show abstract

“…Compared with other real-life studies, we found similar responses in terms of IGA [ 18 ] and EASI75 [ 19 ]. Regarding another real-life experience from Hagino et al .…”

Section: Discussionsupporting

confidence: 79%

Real-Life Effectiveness and Safety of Upadacitinib in Adults and Adolescents with Moderate-to-Severe Atopic Dermatitis: A Single-Center 16-Week Study

Gargiulo

Ibba

Cortese

et al. 2023

Dermatol Ther (Heidelb)

View full text Add to dashboard Cite

show abstract

“…These results are even better than those of the AD Up trial [4] where 40% and 59% of patients achieved a vIGA-AD of 0 or 1 at week 16, respectively, with upadacitinib 15 mg and 30 mg, combined with topical corticosteroids. The effectiveness and tolerance data are also comparable to those of other reallife studies with upadacitinib [6][7][8][9][10][11]. It adds further evidence to recent studies that have shown a superior efficacy of upadacitinib 30 mg to that of baricitinib 2 or 4 mg, dupilumab or tralokinumab [12][13][14].…”

Section: Discussionsupporting

confidence: 77%

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

et al. 2023

View full text Add to dashboard Cite

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 secondline 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 metaanalysis. 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.

show abstract

“…Until now, only a few daily practice studies have been published. Five small cohort studies (with a maximum of 16 patients) showed a good clinical response in most AD patients to upadacitinib treatment, [15][16][17][18][19] including one study that showed adequate disease control in ten patients that failed dupilumab treatment. 15 In addition, three larger real-world studies have been published.…”

Section: Discussionmentioning

confidence: 99%

Upadacitinib treatment in a real‐world difficult‐to‐treat atopic dermatitis patient cohort

Schlösser,

Boeijink,

Olydam

et al. 2023

Acad Dermatol Venereol

View full text Add to dashboard Cite

BackgroundUpadacitinib 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.ObjectivesTo provide real world evidence on the use of upadacitinib treatment in moderate‐to‐severe atopic dermatitis.MethodsIn this prospective observational single‐center study, all AD patients treated with upadacitinib treatment in the context of standard care were included between August 2021 to September 2022. Clinical outcome measures and adverse events (AEs) were analyzed.ResultsForty‐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%).ConclusionsIn 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.

show abstract

Real‐life experience of upadacitinib for the treatment of adult patients with moderate‐to‐severe atopic dermatitis – a case series

Cited by 14 publications

References 4 publications

Real-Life Effectiveness and Safety of Upadacitinib in Adults and Adolescents with Moderate-to-Severe Atopic Dermatitis: A Single-Center 16-Week Study

Real-Life Effectiveness and Safety of Upadacitinib in Adults and Adolescents with Moderate-to-Severe Atopic Dermatitis: A Single-Center 16-Week Study

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

Upadacitinib treatment in a real‐world difficult‐to‐treat atopic dermatitis patient cohort

Contact Info

Product

Resources

About