TY - JOUR
T1 - Effectiveness and Safety of Upadacitinib in Patients with Moderate-to-Severe Atopic Dermatitis and Previous Failures of Th2 Biologics: A Propensity Score-Matched Study
AU - Barei, Francesca
AU - Chiei-Gallo, Alessandra
AU - Narcisi, Alessandra
AU - Ingurgio, Ruggero Cascio
AU - Malagoli, Piergiorgio
AU - Girolomoni, Giampiero
AU - Maurelli, Martina
AU - Pezzolo, Elena
AU - Sciarrone, Claudio
AU - Gola, Massimo
AU - Magliulo, Manfredi
AU - SAVOIA, Paola
AU - Esposto, Elia
AU - Burroni, Anna G
AU - Amoruso, Fabrizio
AU - Bianchi, Vittoria Giulia
AU - Mercuri, Santo R
AU - Satolli, Francesca
AU - De Felici Del Giudice, Maria Beatrice
AU - Pella, Paolo
AU - Pinto, Roberto
AU - Avallone, Gianluca
AU - Gurioli, Carlotta
AU - Piraccini, Bianca Maria
AU - Balato, Anna
AU - Di Brizzi, Eugenia V
AU - Angileri, Rosa Giuseppa
AU - Manzo Margiotta, Flavia
AU - Romanelli, Marco
AU - Rossi, Mariateresa
AU - Guanti, Mario Bruno
AU - Lauretta, Giuseppe
AU - Dastoli, Stefano
AU - Patruno, Cataldo
AU - Napolitano, Maddalena
AU - Ortoncelli, Michela
AU - Ribero, Simone
AU - Marzano, Angelo V
AU - Ferrucci, Silvia
PY - 2025
Y1 - 2025
N2 - Introduction: Real-world data comparing patients with atopic dermatitis (AD) initially treated with upadacitinib versus those previously treated with biologics or other JAK inhibitors are limited. Methods: We conducted a retrospective multicenter study of 524 patients with moderate-to-severe AD treated with upadacitinib to assess clinical outcomes over 52 weeks. A sub-analysis of 316 patients compared outcomes between those who had previously failed Th2 biologics (group A) and those who discontinued these treatments for reasons other than inefficacy or were bio-naïve (group B), using a Propensity Score matching method. Results: A significant clinical improvement starting from week 4 and continuing throughout the study period was observed in the overall population and both in group A and B. Group B showed greater improvements at later follow-up times, with a higher median EASI (Eczema Area and Severity Index) percentage improvement at week 52 (p=0.030), a significantly higher proportion of patients achieving EASI-90 and EASI-100 at week 36 (p=0.023, χ²=9.497). As for the P-NRS (Pruritus Numerical Rating Scale) and SD-NRS (Sleep Distrubances Numerical Rating Scale), group B had a significantly greater percentage of patients reporting a score of 0 or 1 at week 52 (P-NRS: p=0.017, χ²=5.665; SD-NRS: p=0.049, χ²=3.870). Group B also had a significantly higher percentage of patients reaching minimal disease activiy at week 52 (p=0.014, χ²=5.980). Conclusion: Upadacitinib proved to be effective in the long term not only as a first-line therapy but also in patients with a history of biologic treatment failure. However, patients in Group B consistently demonstrated better clinical responses at later follow-ups, suggesting that bio-naïve individuals and those who discontinued Th2 biologics for reasons other than inefficacy may respond more favorably to upadacitinib.
AB - Introduction: Real-world data comparing patients with atopic dermatitis (AD) initially treated with upadacitinib versus those previously treated with biologics or other JAK inhibitors are limited. Methods: We conducted a retrospective multicenter study of 524 patients with moderate-to-severe AD treated with upadacitinib to assess clinical outcomes over 52 weeks. A sub-analysis of 316 patients compared outcomes between those who had previously failed Th2 biologics (group A) and those who discontinued these treatments for reasons other than inefficacy or were bio-naïve (group B), using a Propensity Score matching method. Results: A significant clinical improvement starting from week 4 and continuing throughout the study period was observed in the overall population and both in group A and B. Group B showed greater improvements at later follow-up times, with a higher median EASI (Eczema Area and Severity Index) percentage improvement at week 52 (p=0.030), a significantly higher proportion of patients achieving EASI-90 and EASI-100 at week 36 (p=0.023, χ²=9.497). As for the P-NRS (Pruritus Numerical Rating Scale) and SD-NRS (Sleep Distrubances Numerical Rating Scale), group B had a significantly greater percentage of patients reporting a score of 0 or 1 at week 52 (P-NRS: p=0.017, χ²=5.665; SD-NRS: p=0.049, χ²=3.870). Group B also had a significantly higher percentage of patients reaching minimal disease activiy at week 52 (p=0.014, χ²=5.980). Conclusion: Upadacitinib proved to be effective in the long term not only as a first-line therapy but also in patients with a history of biologic treatment failure. However, patients in Group B consistently demonstrated better clinical responses at later follow-ups, suggesting that bio-naïve individuals and those who discontinued Th2 biologics for reasons other than inefficacy may respond more favorably to upadacitinib.
UR - https://iris.uniupo.it/handle/11579/212423
U2 - 10.1093/ced/llaf253
DO - 10.1093/ced/llaf253
M3 - Article
SN - 0307-6938
JO - Clinical and Experimental Dermatology
JF - Clinical and Experimental Dermatology
ER -