Comparison of Long-Term Effectiveness and Safety of Upadacitinib for Atopic Dermatitis Between Dupilumab-Exposed and Dupilumab-Naïve Patients

Management of Patients Affected by Moderate-to-Severe Atopic Dermatitis with JAK Inhibitors in Real-World Clinical Practice: An Italian Delphi Consensus

“…Concerning the real-world effectiveness and safety of JAK inhibitors, data from scientific literature have confirmed data from clinical trials from all three drugs [ 5 – 7 , 9 ]. In particular, abrocitinib and upadacitinib have shown very high rates of EASI 90 and EASI 100, comparable or superior to phase III clinical trials [ 4 , 17 ].…”

“…Ten statements were generated on this topic, and they all reached agreement during the first Delphi round. In particular, statements 7–10 highlighted the high effectiveness profiles of all the approved JAK inhibitors, according to data from both clinical trials and real-world experience in terms of both clinical improvement and patient-reported outcomes (PROs) [ 4 – 9 ]. In particular, upadacitinib and abrocitinib have demonstrated high rates of EASI 75 and EASI 90 (reduction of at least 75% and 90% of the Eczema Area and Severity Index compared to baseline), along with rapid decrease of the itch and improvement in the quality of life, across all patient groups (biological-naive versus biological-experienced, different phenotypes) [ 4 , 19 ].…”

“…In particular, according to European guidelines, patients with severe AD should be treated with biological drugs (such as dupilumab and tralokinumab) or Janus kinase (JAK) inhibitors, such as abrocitinib, baricitinib, and upadacitinib [ 3 ]. JAK inhibitors have shown efficacy and safety in multiple phase III clinical trials and in a few initial real-world experiences [ 4 – 9 ]. However, a few concerns have been raised regarding their long-term safety and the management of these drugs in real-world clinical practice [ 7 , 10 ].…”

Effects of abrocitinib on pruritus and eczema symptoms and tolerance in patients with moderate‑to‑severe atopic dermatitis in randomized, double‑blind and placebo‑controlled trials: A systematic review and a meta‑analysis

“…According to the systematic review plan, inclusion criteria were determined in strict accordance with the patients, interventions, comparisons, outcomes and study design principles ( 29 ). Inclusion criteria were as follows: i) Patients with clinical diagnosis of moderate-to-severe AD ( 30 ); ii) patients aged ≥18 years; iii) test group received 100 and/or 200 mg abrocitinib (orally, once daily), whilst the control group received placebo; iv) investigator's global assessment (IGA) score was used as the efficacy indicator ( 31 ); v) 50, 75 and 90% response rates of eczema area and severity index (EASI) ( 32 , 33 ) and the pruritus numerical rating scale (P-NRS) were used ( 31 ); vi) adverse reaction symptoms with an event rate of >2 were used as the evaluation indices for safety; vii) double-blind RCT and viii) written in English or Chinese. Example of adverse events include gastrointestinal dysfunction, nausea, infection and infestation, upper respiratory tract infection, upper respiratory tract viral infection, dizziness, headache, skin and subcutaneous disease, elevated creatine phosphokinase, thrombocytopenia and serious adverse events (such as asthma, exacerbation of dermatitis, malignant melanoma and pulmonary embolism).…”