The differential effects of upadacitinib treatment on skin rashes of four anatomical sites in patients with atopic dermatitis

Hagino, Teppei; Saeki, Hidehisa; Fujimoto, Eita; Kanda, Naoko

doi:10.1080/09546634.2023.2212095

Cited by 11 publications

(4 citation statements)

References 18 publications

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“…We recently reported that the percentage reduction of EASI on the head and neck was significantly lower than that on lower limbs at week 12 of treatment with upadacitinib 7 and with JAK1/2 inhibitor baricitinib 8 . The lower therapeutic effectiveness for head‐and‐neck rash was also revealed in dupilumab treatment 26 .…”

Section: Discussionmentioning

confidence: 95%

“…Among different anatomical sites, head and neck, upper limbs, lower limbs, and trunk, upadacitinib appeared most effective for the rash on lower limbs and less effective for those on the head and neck and on the trunk 7 . JAK1/2 inhibitor baricitinib was more effective for rash on the lower limbs than on the head and neck 8 .…”

Section: Introductionmentioning

confidence: 99%

“…5,6 Among different anatomical sites, head and neck, upper limbs, lower limbs, and trunk, upadacitinib appeared most effective for the rash on lower limbs and less effective for those on the head and neck and on the trunk. 7 JAK1/2 inhibitor baricitinib was more effective for rash on the lower limbs than on the head and neck. 8 However, the specific effects of oral JAK inhibitors on individual rash types of AD, erythema, edema/population, excoriation, or lichenification have not been precisely examined in clinical practice.…”

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confidence: 94%

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Therapeutic effectiveness of upadacitinib on individual types of rash in Japanese patients with moderate‐to‐severe atopic dermatitis

Hagino,

Yoshida,

Hamada

et al. 2023

The Journal of Dermatology

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Atopic dermatitis (AD) is a chronic eczematous disease with various types of rash, erythema, edema/papulation, excoriation, or lichenification. Janus kinase 1 inhibitor upadacitinib is effective for moderate‐to‐severe AD. We aimed to investigate the therapeutic effects of upadacitinib on each rash type in AD patients in real‐world clinical practice. Seventy‐two Japanese patients with moderate‐to‐severe AD were treated with oral upadacitinib 15 mg/day plus topical corticosteroids. The Eczema Area and Severity Index (EASI) scores for erythema, edema/papulation, excoriation, or lichenification on the whole body or on head and neck, upper limbs, lower limbs, or trunk were assessed at weeks 0, 4, and 12 of treatment. The proportions of patients who achieved resolution or at least 75% reduction of EASI from baseline (EASI 75) for individual rash types were calculated at weeks 4 and 12 on the whole body or each anatomical site. The resolution rates for excoriation, erythema, edema/papulation, or lichenification on the whole body were 38.3%, 23.7%, 21.7%, and 8.3% at week 4 and 18.3%, 18.6%, 11.6%, and 13.3% at week 12, respectively. The EASI scores for all rash types significantly decreased at weeks 4 and 12 compared to week 0. The achievement rates of EASI 75 for excoriation, erythema, edema/papulation, or lichenification on the whole body were 67.2%, 66.7%, 49.2%, and 37.7% at week 4 and 57.3%, 65%, 41%, and 41% at week 12, respectively. The achievement rate of EASI 75 for erythema on head and neck at week 4 (45.3%) was lower than that on upper limbs (71%) and on lower limbs (70.8%), and that on head and neck at week 12 (42.2%) was lower than that on lower limbs (69.2%). These results indicate that upadacitinib is effective for all AD rash types, especially for excoriation and erythema, while head‐and‐neck erythema might be less responsive to upadacitinib.

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Section: Discussionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 99%

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confidence: 94%

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Therapeutic effectiveness of upadacitinib on individual types of rash in Japanese patients with moderate‐to‐severe atopic dermatitis

Hagino,

Yoshida,

Hamada

et al. 2023

The Journal of Dermatology

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“…Among oral JAK inhibitors approved in Japan, upadacitinib has shown significant therapeutic effectiveness and safety for moderateto-severe AD, both in clinical trials (4)(5)(6)(7)(8)(9)(10)(11)(12) and real-world clinical practice (13). Selective inhibition of JAK1 by upadacitinib targets specific pathways involved in AD, differentiated from firstgeneration pan-JAK inhibitors such as tofacitinib and ruxolitinib, which inhibit multiple JAK pathways (14).…”

Section: Introductionmentioning

confidence: 99%

Total eosinophil count as a biomarker for therapeutic effects of upadacitinib in atopic dermatitis over 48 weeks

Hagino,

Hamada,

Yoshida

et al. 2024

Front. Immunol.

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BackgroundAtopic dermatitis (AD) is a chronic skin disease characterized by type 2-skewed immune responses, and significantly influenced by cytokines dependent on Janus kinases (JAKs). Upadacitinib, a JAK1 inhibitor, is effective for moderate-to-severe AD. This study aims to identify biomarkers that reflect long-term therapeutic effects of upadacitinib 15 mg or 30 mg.MethodsA retrospective study from August 2021 to July 2023 included 213 AD patients treated with upadacitinib 15 mg and 70 AD patients with 30 mg. We analyzed eczema area and severity index (EASI), peak pruritus-numerical rating scale (PP-NRS), serum immunoglobulin E (IgE), thymus and activation-regulated chemokine (TARC), lactate dehydrogenase (LDH), and total eosinophil count (TEC) at weeks 0, 4, 12, 24, 36, and 48 of treatment.ResultsBoth treatments with upadacitinib 15 mg and 30 mg significantly reduced EASI and PP-NRS scores over week 4 to 48 compared to baseline. Upadacitinib 15 mg or 30 mg treatment significantly decreased TEC compared to baseline through week 4 to 36 or week 4 to 48, respectively. The percent reduction of TEC correlated with those of EASI and PP-NRS through week 4 to 48 of treatment with upadacitinib 15 mg, or through week 12 to 48 with 30 mg, respectively. After adjusting for % reductions of other laboratory markers, the significance of correlations was preserved at weeks 36 and 48 of 15 mg treatment, while at weeks 4 and 36 of 30 mg treatment.ConclusionThe % reduction of TEC correlated with those of EASI and PP-NRS during upadacitinib treatment, indicating its potential as a biomarker reflecting treatment responses to upadacitinib in AD patients. However, the variability of significant correlation during treatment indicates that further inspection is needed for its usefulness in monitoring responses to upadacitinib treatment for AD.

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Effectiveness of Dose Increase in Upadacitinib from 15 mg to 30 mg for Patients with Moderate-to-Severe Atopic Dermatitis: A Real-World Clinical Practice in Japan

Hagino,

Hamada,

Yoshida

et al. 2024

Clin Drug Investig

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The differential effects of upadacitinib treatment on skin rashes of four anatomical sites in patients with atopic dermatitis

Cited by 11 publications

References 18 publications

Therapeutic effectiveness of upadacitinib on individual types of rash in Japanese patients with moderate‐to‐severe atopic dermatitis

Therapeutic effectiveness of upadacitinib on individual types of rash in Japanese patients with moderate‐to‐severe atopic dermatitis

Total eosinophil count as a biomarker for therapeutic effects of upadacitinib in atopic dermatitis over 48 weeks

Effectiveness of Dose Increase in Upadacitinib from 15 mg to 30 mg for Patients with Moderate-to-Severe Atopic Dermatitis: A Real-World Clinical Practice in Japan

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