Upadacitinib improved alopecia areata in a patient with atopic dermatitis: A case report

Cantelli, Mariateresa; Fabbrocini, Gabriella; Patruno, Cataldo; Nappa, Paola; Fabbrocini, Gabriella; Napolitano, Maddalena

doi:10.1111/dth.15346

Cited by 42 publications

(41 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Brepocitinib (PF-06700841) is an inhibitor of JAK1 and TYK2 that was initially shown to be effective in treating patients with plaque psoriasis ( Table 1 ) ( 95 ). Efficacy for brepocitinib for treating AA was demonstrated in the recently reported ALLEGRO trial, where it was tested in parallel with ritlecitinib, which is discussed further below.…”

Section: Second Generation Jak Inhibitorsmentioning

confidence: 99%

An overview of JAK/STAT pathways and JAK inhibition in alopecia areata

Lensing

Jabbari

2022

Front. Immunol.

View full text Add to dashboard Cite

Alopecia Areata (AA) is a common autoimmune disease characterized by non-scarring hair loss ranging from patches on the scalp to complete hair loss involving the entire body. Disease onset is hypothesized to follow the collapse of immune privilege of the hair follicle, which results in an increase in self-peptide/MHC expression along the follicular epithelium. Hair loss is associated with infiltration of the hair follicle with putatively self-reactive T cells. This process is thought to skew the hair follicle microenvironment away from a typically homeostatic immune state towards one of active inflammation. This imbalance is mediated in part by the dominating presence of specific cytokines. While interferon-γ (IFNγ) has been identified as the key player in AA pathogenesis, many other cytokines have also been shown to play pivotal roles. Mechanistic studies in animal models have highlighted the contribution of common gamma chain (γc) cytokines such as IL-2, IL-7, and IL-15 in augmenting disease. IFNγ and γc cytokines signal through pathways involving receptor activation of Janus kinases (JAKs) and signal transducers and activators of transcription (STATs). Based on these findings, JAK/STAT pathways have been targeted for the purposes of therapeutic intervention in the clinical setting. Case reports and series have described use of small molecule JAK inhibitors leading to hair regrowth among AA patients. Furthermore, emerging clinical trial results show great promise and position JAK inhibitors as a treatment strategy for patients with severe or recalcitrant disease. Demonstrated efficacy from large-scale clinical trials of the JAK inhibitor baricitinib led to the first-in-disease FDA-approved treatment for AA in June of 2022. This review aims to highlight the JAK/STAT signaling pathways of various cytokines involved in AA and how targeting those pathways may impact disease outcomes in both laboratory and clinical settings.

show abstract

Section: Second Generation Jak Inhibitorsmentioning

confidence: 99%

An overview of JAK/STAT pathways and JAK inhibition in alopecia areata

Lensing

Jabbari

2022

Front. Immunol.

View full text Add to dashboard Cite

show abstract

“…1 One study showed an 89% reduction in AD disease severity and an 800% increase in use of emollients when a specialized dermatology nurse performed repeated education and demonstration of proper topical therapy application. 2 However, nurses working outside of the dermatology clinics might not have the same structured education or health knowledge as those working with AD daily. With approximately 50% of AD management taking place in primary care settings, 3 educational interventions that improve primary care nurses' eczema knowledge should enhance the counseling and education that nurses provide to patients by addressing the psychosocial challenges and knowledge gaps that patients have.…”

Section: Evaluation Of a Comprehensive Web-based Educational Program ...mentioning

confidence: 99%

“…Recently, upadacitinib, a selective JAK-1 inhibitor, has been incorporated for AD treatment. Real clinical practice studies are scarce, with only a few case series 1–4 …”

mentioning

confidence: 99%

Upadacitinib for the Treatment of Atopic Dermatitis in a Spanish Cohort—Real Life: Fifty-Two–Week Follow-up Results

Pereyra‐Rodriguez¹,

Pinto²,

Figuras-Nart³

et al. 2022

Dermatitis

View full text Add to dashboard Cite

Atopic dermatitis (AD) is a chronic, inflammatory, and pruritic skin disease. Recently, upadacitinib, a selective JAK-1 inhibitor, has been incorporated for AD treatment. Real clinical practice studies are scarce, with only a few case series. [1][2][3][4] In this multicenter retrospective study, upadacitinib was evaluated in a series of patients with moderate to severe AD included in premarketing programs in Spain. Data collected included age, disease duration, comorbidities, and previous treatments. Disease severity was measured by SCORing Atopic Dermatitis (SCORAD), Eczema Area and Severity Index (EASI), investigator's global assessment (IGA) body surface area, Dermatology Life Quality Index, Peak Pruritus Numerical Rating Scale (PP-NRS), and blood test parameters (eosinophil count, total immunoglobulin E, hemoglobin, low-density lipoprotein and high-density lipoprotein cholesterol, triglycerides, creatine phosphokinase, gamma-glutamyl transferase, glutamic oxaloacetic transaminase and glutamic pyruvic transaminase levels) at the baseline visit and at weeks 4, 16, 24, and 52.Twenty-two patients were included in the study. Demographic and baseline characteristics are shown in Table 1. Approved 15-or 30-mg daily doses were prescribed at the discretion of the prescribing physician, with no changes during the follow-up period. All values improved rapidly from week 4 of follow-up (Figs. 1A-D). Mean EASI decreased to 4.4 ± 5.2 (84.2% improvement), SCORAD to 18.5 ± 22.8 (69.2% improvement), and PP-NRS to 2.4 ± 2.9 (70.0% improvement) at week 52 ( P < 0.0001 for

show abstract

“… 85 , 86 No data of atopic dermatitis worsening in patients undergoing treatment with janus kinase inhibitors are available. 87 , 88 Concerning hidradenitis suppurativa, there are currently few cases of new-onset disease (n = 1) 89 or disease exacerbation (n = 5). 90 However, patients with hidradenitis suppurativa are not at higher risk for any COVID-19 vaccine‐related adverse outcomes.…”

Section: Resultsmentioning

confidence: 99%

Cutaneous Reactions Following COVID-19 Vaccination: A Review of the Current Literature

Battista¹,

Marasca²,

Genco³

et al. 2022

CCID

Self Cite

View full text Add to dashboard Cite

The outbreak of coronavirus disease 2019 represented a new worldwide challenge, strongly impacting on the global economy, overall health and lifestyle. Since then, several strategies have been adopted to contain the widespread of infection. Among these, vaccination is currently the most important measure to fight against the pandemic. However, several concerns such as slower-than-hoped-for rollout, the hurried approval with limited data, the mechanism of action (in particular mRNA-based), and the uncertain duration of protection they afforded were initially raised. Moreover, even if cutaneous reactions have been rarely reported in clinical trials, global mass vaccination showed several dermatologic reactions not initially recognized, leaving dermatologists to decide how to diagnose and treat them. In this scenario, dermatologists should be ready to promptly recognize these clinical manifestations. Thus, the aim of this manuscript is to review current literature on cutaneous reactions following COVID-19 vaccination, particularly inflammatory dermatological diseases, in order to help clinicians to better understand these dermatological conditions and to provide an extensive overview of all the vaccine-related skin manifestations.

show abstract

Upadacitinib improved alopecia areata in a patient with atopic dermatitis: A case report

Cited by 42 publications

References 8 publications

An overview of JAK/STAT pathways and JAK inhibition in alopecia areata

An overview of JAK/STAT pathways and JAK inhibition in alopecia areata

Upadacitinib for the Treatment of Atopic Dermatitis in a Spanish Cohort—Real Life: Fifty-Two–Week Follow-up Results

Cutaneous Reactions Following COVID-19 Vaccination: A Review of the Current Literature

Contact Info

Product

Resources

About