Treatment of atopic dermatitis with upadacitinib: adcare single center experience

Daria S Fomina; Olga A Mukhina; Valeria I Mikhailova; Marina S Lebedkina; Elizaveta L Sedova; Elena N Bobrikova; Olga G Elisyutina; Elena S Fedenko; Tair T Nurpeisov; Alexander V Karaulov; Mar'yana A Lysenko; Luis Felipe C Ensina

doi:10.3389/fmed.2024.1385720

Treatment of atopic dermatitis with upadacitinib: adcare single center experience

Front Med (Lausanne). 2024 Apr 17:11:1385720. doi: 10.3389/fmed.2024.1385720. eCollection 2024.

Authors

Affiliations

¹ City Clinical Hospital No. 52 of the Moscow Healthcare Department, State Budgetary Healthcare Institution, Moscow, Russia.
² I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia.
³ NRC Institute of Immunology FMBA of Russia, Moscow, Russia.
⁴ Peoples' Friendship University of Russia (RUDN University), Moscow, Russia.
⁵ Department of General Immunology, Asfendiyarov Kazakh National Medical University (KazNMU), Almaty, Kazakhstan.
⁶ Republican Allergy Center, Research Institute of Cardiology and Internal Medicine, Almaty, Kazakhstan.
⁷ Pirogov Russian National Research Medical University, Moscow, Russia.
⁸ Division of Allergy, Immunology, Rheumatology, Department of Pediatrics, Federal University of São Paulo, São Paulo, Brazil.

Abstract

Introduction: The role of upadacitinib in the management of moderate to severe atopic dermatitis seems promising, but more data on its efficacy and safety are needed. This study endeavors to assess the practical impact and safety of upadacitinib in patients with moderate to severe atopic dermatitis. The study aims to evaluate the efficacy and safety of upadacitinib in the treatment of moderate to severe atopic dermatitis, focusing on analyzing patient responses to the treatment.

Methods: In this study, adult patients diagnosed with moderate to severe atopic dermatitis received upadacitinib at daily doses of 15 mg or 30 mg, as prescribed by their attending physicians. The therapeutic efficacy of upadacitinib was meticulously assessed using established clinical metrics. Simultaneously, a comprehensive safety assessment was conducted through monthly monitoring, including the evaluation of potential effects of upadacitinib intake on hepatic function, lipid profile, and hematopoiesis using the pertinent laboratory tests.

Results: Sixteen participants were enrolled in the study. At 1month follow-up, there was a significant reduction in the mean Eczema Area and Severity Index (EASI) score to 18.8 points, which further increased to 24 points at the 4-month mark. Additionally, 9 participants (56%) demonstrated an EASI-50 response after 1 month of treatment, with this response increasing to 9 participants (90%) after 4 months. Furthermore, enhanced therapeutic responses were observed at 4 months, with 6 patients (38%) achieving an EASI-75 response at 1month and 8 patients (80%) achieving this milestone at the 4-month follow-up. This study highlights the potential of upadacitinib as an effective treatment option for moderate to severe atopic dermatitis. While it demonstrates improved symptom management, close monitoring for potential adverse events, particularly infections and the known risks of Janus kinase inhibitors, is essential. Further research is essential to determine the long-term safety and efficacy of upadacitinib.

Keywords: Eczema Area and Severity Index; Janus kinase inhibitors molecules; atopic dermatitis; drug efficacy and safety; upadacitinib.

Grants and funding

The author(s) declare that no financial support was received for the research, authorship, and/or publication of this article. This study was supported by the Moscow Center for Innovative Technologies in Healthcare.