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Zhou S, Lei L, Jiang L, Fu C, Huang J, Zhang K, Wen Y, Chen J, Zeng Q. Adverse event of ruxolitinib cream: a real-world analysis based on FDA Adverse Event Reporting System from 2021 to 2024. Expert Opin Drug Saf 2024:1-6. [PMID: 39707983 DOI: 10.1080/14740338.2024.2446432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2024] [Revised: 11/28/2024] [Accepted: 11/29/2024] [Indexed: 12/23/2024]
Abstract
BACKGROUND Ruxolitinib cream, a topical Janus kinase (JAK) inhibitor, is a widely used treatment for various dermatological diseases. This study employs the FDA Adverse Event Reporting System (FAERS) database to examine adverse events (AEs) associated with ruxolitinib cream. METHODS This study employed disproportionate analysis methods, including reported odds ratio and proportional reporting ratio, to collate AEs reported from the fourth quarter of 2021 to the first quarter of 2024. RESULTS After data processing, 803 reports involving ruxolitinib cream were analyzed. Statistically significant signals were identified for 4 system organ classes (SOCs) and 29 preferred terms (PTs). The most notable signal observed in the SOCs was associated with skin and subcutaneous tissue disorders. For PTs, the AEs observed included clinical symptoms such as pruritus, skin irritation, and burning sensations, as well as signs such as rash, scratching, erythema, and dry skin. Additionally, other observed AEs included diseases such as acne, drug hypersensitivity, and herpes zoster. CONCLUSIONS This study offers insights into the safety of ruxolitinib cream, improving understanding of its AEs and guiding safer clinical practices. However, the FAERS database lacks data on AE severity and the ability to establish causality, requiring further research to clarify mechanisms behind certain AEs.
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Affiliation(s)
- Shu Zhou
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Li Lei
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Ling Jiang
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Chuhan Fu
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Jiangfeng Huang
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Keyi Zhang
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Yaqing Wen
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Jing Chen
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, China
| | - Qinghai Zeng
- Department of Dermatology, Third Xiangya Hospital, Central South University, Changsha, China
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2
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Yang Y, Chen J, Xiong S, Zhang J, Ye Q, Xue R, Tian X, Zhong J, Zhu H, Gao A, Liu Y. Comparative effectiveness of upadacitinib versus dupilumab for moderate-to-severe atopic dermatitis: A retrospective cohort study. Int Immunopharmacol 2024; 143:113383. [PMID: 39405928 DOI: 10.1016/j.intimp.2024.113383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2024] [Revised: 10/07/2024] [Accepted: 10/08/2024] [Indexed: 10/30/2024]
Abstract
BACKGROUND Although efficacy and safety of Upadacitinib and Dupilumab in moderate to severe atopic dermatitis (AD) have been shown in clinical trials, real world data are still limited. The aim of this retrospective study is to indirectly compare the efficacy and safety of Upadacitinib and Dupilumab in patients with moderate to severe AD in real world practice. METHODS A single-center retrospective cohort study was conducted. The study included patients with moderate to severe AD, who were enrolled from May 2022 to March 2024, to indirectly compare the efficacy and safety of Upadacitinib and Dupilumab over 12 weeks duration. RESULTS Eighty-seven patients were included (46 received Upadacitinib and 41 Dupilumab). Compared with week 0, there was a significant decrease in EASI score, ADCT score and NRS score in patients of both groups in weeks 4, 8, and 12. In week 4, the reduction in EASI score, ADCT score and NRS score was significantly greater in patients of Upadacitinib group compared to those in Dupilumab group. Compared to baseline, in week 12, the decrease in IL-4, IL-13, and IL-31 level in the serum of patients in Upadacitinib group was significantly greater than that of patients in Dupilumab group. The total IgE of patients in Dupilumab group decreased significantly, while there was no significant change in patients of Upadacitinib group. Although Upadacitinib group reported more adverse events than Dupilumab group, no serious adverse events were observed. CONCLUSIONS Both Upadacitinib and Dupilumab groups showed effective trend in patients with moderate to severe AD. Upadacitinib has better efficacy and rapid onset in the treatment of patients with moderate to severe AD.
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Affiliation(s)
- Yan Yang
- Department of Dermatology, Guangzhou Dermatology Hospital, Guangzhou, Guangdong 510095, PR China
| | - Jiaoquan Chen
- Department of Dermatology, Guangzhou Dermatology Hospital, Guangzhou, Guangdong 510095, PR China
| | - Siyin Xiong
- Department of Dermatology, Guangzhou Dermatology Hospital, Guangzhou, Guangdong 510095, PR China
| | - Jing Zhang
- Department of Dermatology, Guangzhou Dermatology Hospital, Guangzhou, Guangdong 510095, PR China
| | - Qianru Ye
- Department of Dermatology, Guangzhou Dermatology Hospital, Guangzhou, Guangdong 510095, PR China
| | - Rujun Xue
- Department of Dermatology, Guangzhou Dermatology Hospital, Guangzhou, Guangdong 510095, PR China
| | - Xin Tian
- Department of Dermatology, Guangzhou Dermatology Hospital, Guangzhou, Guangdong 510095, PR China
| | - Jiemin Zhong
- Department of Dermatology, Guangzhou Dermatology Hospital, Guangzhou, Guangdong 510095, PR China
| | - Huilan Zhu
- Department of Dermatology, Guangzhou Dermatology Hospital, Guangzhou, Guangdong 510095, PR China
| | - Aili Gao
- Department of Dermatology, Guangzhou Dermatology Hospital, Guangzhou, Guangdong 510095, PR China.
| | - Yumei Liu
- Department of Dermatology, Guangzhou Dermatology Hospital, Guangzhou, Guangdong 510095, PR China.
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Hagino T, Saeki H, Fujimoto E, Kanda N. Effectiveness and safety of deucravacitinib treatment for moderate-to-severe psoriasis in real-world clinical practice in Japan. J DERMATOL TREAT 2024; 35:2307489. [PMID: 38305215 DOI: 10.1080/09546634.2024.2307489] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Accepted: 01/15/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND Deucravacitinib is a selective oral tyrosine kinase 2 (TYK2) inhibitor recently approved for psoriasis. OBJECTIVES We aimed to evaluate the real-world effectiveness and safety of deucravacitinib for psoriasis. METHODS We analyzed 33 Japanese patients with psoriasis (23 with plaque psoriasis, eight with psoriatic arthritis, and two with erythrodermic psoriasis) from January 2023 to October 2023. All patients received deucravacitinib 6 mg daily until week 16. RESULTS At week 8, 12, or 16, the achievement rate of PASI 75 was 60.9%, 73.9%, or 78.3%, that of PASI 90 was 13.0%, 39.1%, or 52.2%, that of PASI 100 was 0%, 8.7%, or 13.0%, that of absolute PASI ≤2 was 34.8%, 65.2%, or 78.3%, respectively. The achievement rate of dermatology life quality index 0/1 at week 16 was 42.9%. Fourteen patients (42%) complained pruritus. Peak pruritus-numerical rating scale in patients with pruritus decreased by median [interquartile] 71.4 [50-80] % of baseline at week 2. Adverse events occurred in 18.2% of patients, which were mild and manageable. CONCLUSIONS Deucravacitinib for patients with psoriasis was well-tolerated and gave favorable therapeutic effects in the real-world practice. Deucravacitinib treatment rapidly reduced pruritus.
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Affiliation(s)
- Teppei Hagino
- Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan
| | - Hidehisa Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | | | - Naoko Kanda
- Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan
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4
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Hagino T, Yoshida M, Hamada R, Saeki H, Fujimoto E, Kanda N. Predictive factors for responders to upadacitinib treatment in patients with atopic dermatitis. J DERMATOL TREAT 2024; 35:2310643. [PMID: 38297496 DOI: 10.1080/09546634.2024.2310643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 01/22/2024] [Indexed: 02/02/2024]
Abstract
BACKGROUND Janus kinase 1 inhibitor upadacitinib is therapeutically effective for atopic dermatitis (AD). However, predictive factors for high responders to upadacitinib have not been established in real-world clinical practice. OBJECTIVES To identify predictive factors for responders to upadacitinib 15 mg or 30 mg, defined as achievers of investigator's global assessment (IGA) 0/1 with ≥ 2-point improvement from basal IGA. METHODS A retrospective study was conducted from August 2021 to July 2023 on 159 AD patients treated with upadacitinib 15 mg and 52 patients with 30 mg. Patients in each group were categorized into responders (achievers of IGA 0/1 at week 12) and non-responders (non-achievers). We compared baseline values of clinical and laboratory parameters between responders and non-responders. Logistic regression analysis was used to detect variables predicting responders. Receiver-operating characteristic curves were used for evaluating prediction capabilities of the variables. RESULTS In logistic regression analysis, responders to 15 mg upadacitinib were associated with lower total EASI and higher age whereas responders to 30 mg were associated with lower LDH and lower IgE. CONCLUSIONS Lower total EASI and higher age may predict responders to upadacitinib 15 mg while lower IgE and lower LDH may predict responders to 30 mg.
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Affiliation(s)
- Teppei Hagino
- Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan
| | - Mai Yoshida
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Risa Hamada
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Hidehisa Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | | | - Naoko Kanda
- Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan
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Melgosa-Ramos FJ, Vicente Villa A, Betlloch Mas I, Santos-Alarcón S. Mid-term Safety and Efficacy of Upadacitinib in Adolescents With Moderate-to-severe Atopic Dermatitis: A Real-life 34-Patient Multicenter Trial. ACTAS DERMO-SIFILIOGRAFICAS 2024:S0001-7310(24)00885-8. [PMID: 39542353 DOI: 10.1016/j.ad.2024.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 07/20/2024] [Accepted: 08/14/2024] [Indexed: 11/17/2024] Open
Affiliation(s)
- F J Melgosa-Ramos
- Department of Dermatology, Hospital Lluís Alcanyís, Xátiva, Valencia, Spain.
| | - A Vicente Villa
- Department of Dermatology, Hospital Sant Joan de Deu, Barcelona, Spain
| | - I Betlloch Mas
- Department of Dermatology, University General Hospital, Alicante, Spain
| | - S Santos-Alarcón
- Department of Dermatology, Hospital Virgen de los Lirios, Alcoy, Alicante, Spain
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Guttman-Yassky E, Esfandiari E, Mano H, Arai T, Irvine AD, Cork MJ, Kabashima K, Chong C, Simpson E. Durable improvements in atopic dermatitis in the head and neck and across other anatomic regions with rocatinlimab. Arch Dermatol Res 2024; 316:747. [PMID: 39503757 PMCID: PMC11541253 DOI: 10.1007/s00403-024-03426-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2024] [Revised: 09/20/2024] [Accepted: 09/30/2024] [Indexed: 11/09/2024]
Abstract
In a randomized phase 2b trial (NCT03703102) for adult patients with moderate-to-severe atopic dermatitis (AD), treatment with the T cell rebalancing anti-OX40 receptor antibody rocatinlimab (AMG 451/KHK4083) led to significant improvements in clinical measurements versus placebo including whole-body Eczema Area and Severity Index (EASI) score. AD manifestations can impact variable anatomic regions, and involvement of the head and neck, a sensitive, hard-to-treat area, can negatively impact quality of life. In this post hoc analysis, we investigated response to rocatinlimab treatment across anatomic regions, including the head and neck. Least squares mean change from baseline to Week 56 in EASI score was analyzed by anatomic region (head and neck, trunk, upper extremities, or lower extremities) for patients with baseline moderate-to-severe AD in the respective anatomic region, using mixed models for repeated measures. Rocatinlimab groups were compared with placebo at Week 16. The proportion of patients achieving at least 75% reduction from baseline in EASI (EASI-75) was calculated. Probability of relapsing in EASI-75 during the off-treatment follow-up period (Weeks 36-56) was estimated using a Kaplan - Meier approach. At Week 16, decrease from baseline in mean EASI score was greater with all rocatinlimab regimens versus placebo across all anatomic regions for patients with baseline moderate-to-severe AD in the respective region (all P < 0.001). EASI scores continued to improve on treatment after Week 16 and were maintained during the off-treatment period across all regions. Among patients with baseline moderate-to-severe AD in the head and neck (n = 219; rocatinlimab, n = 174; placebo, n = 45), mean difference (rocatinlimab vs placebo) at Week 16 in LS mean percent change in head and neck EASI score ranged from - 30.4% to - 42.6% across treatment regimens. In patients who received rocatinlimab from the start of the trial, 47% - 71% achieved EASI-75 in the head and neck at Week 36. Among EASI-75 responders at Week 36, the probability of relapsing in EASI-75 in any region was low (< 25% in the head and neck) 20 weeks after treatment discontinuation until Week 56.Rocatinlimab treatment led to durable improvements in AD across multiple anatomic regions, including the sensitive head and neck region.
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Affiliation(s)
- Emma Guttman-Yassky
- Department of Dermatology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | | | | | - Alan D Irvine
- Department of Clinical Medicine, University of Dublin Trinity College, Dublin, Republic of Ireland
| | - Michael J Cork
- Sheffield Dermatology Research, University of Sheffield, Sheffield, UK
| | | | | | - Eric Simpson
- Department of Dermatology, Oregon Health & Science University, Portland, OR, USA
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7
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Liu QY, Liu HF, Ye LQ, Li T, Chen ZM, Wang Y, Peng Z, Wan L. Vascular Endothelial Growth Factor a Promotes Chronic Itch via VEGFA-VEGFR2-PI3K-TRPV1 Axis in Allergic Contact Dermatitis. J Inflamm Res 2024; 17:7423-7439. [PMID: 39435259 PMCID: PMC11492922 DOI: 10.2147/jir.s470094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2024] [Accepted: 09/27/2024] [Indexed: 10/23/2024] Open
Abstract
Introduction Allergic contact dermatitis (ACD), a prevalent skin disorder affecting up to 20% of the population, triggers significant discomfort and health implications. Our research investigates the pivotal role of Vascular Endothelial Growth Factor A (VEGFA) in chronic itching associated with ACD. Methods Bioinformatics methods were utilized to identify differentially expressed genes (DEGs) between ACD models and patients. In vivo models of chronic pruritus in mice induced by 2,4-dinitrofluorobenzene (DNFB) were employed. Mice were administered subcutaneously with a VEGFA inhibitor, sFlt1, and compared to a control group. Real-time RT-PCR, Western blot, and immunohistochemical staining were performed to evaluate VEGFA expression and the impact of sFlt1 on itching behavior. Results The analysis revealed that VEGFA is significantly upregulated in ACD skin, primarily expressed by keratinocytes. Administration of the VEGFA inhibitor sFlt1 in the ACD mouse model led to a substantial reduction in scratching behavior, indicating that VEGFA may mediate pruritus through the VEGFA-VEGFR2-PI3K-TRPV1 signaling pathway. Discussion These findings suggest that VEGFA plays a crucial role in ACD-associated pruritus and may serve as a potential therapeutic target. However, further research is required to validate these findings and to explore additional molecular pathways involved in the pruritic response in ACD.
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Affiliation(s)
- Qin-Yu Liu
- Department of Pain Medicine, The State Key Clinical Specialty in Pain Medicine, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510260, People’s Republic of China
- Central Laboratory, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, 510260, People’s Republic of China
| | - Hua-Feng Liu
- Department of Pain Medicine, The State Key Clinical Specialty in Pain Medicine, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510260, People’s Republic of China
- Central Laboratory, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, 510260, People’s Republic of China
| | - Liu-Qing Ye
- Department of Pain Medicine, The State Key Clinical Specialty in Pain Medicine, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510260, People’s Republic of China
- Central Laboratory, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, 510260, People’s Republic of China
| | - Tian Li
- Department of Pain Medicine, The State Key Clinical Specialty in Pain Medicine, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510260, People’s Republic of China
- Central Laboratory, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, 510260, People’s Republic of China
| | - Zuo-Ming Chen
- Department of Pain Medicine, The State Key Clinical Specialty in Pain Medicine, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510260, People’s Republic of China
- Central Laboratory, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, 510260, People’s Republic of China
| | - Yu Wang
- Department of Pain Medicine, The State Key Clinical Specialty in Pain Medicine, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510260, People’s Republic of China
- Central Laboratory, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, 510260, People’s Republic of China
| | - Zhe Peng
- Department of Pain Medicine, The State Key Clinical Specialty in Pain Medicine, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510260, People’s Republic of China
- Central Laboratory, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, Guangdong, 510260, People’s Republic of China
| | - Li Wan
- Department of Pain Medicine, The State Key Clinical Specialty in Pain Medicine, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, 510260, People’s Republic of China
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Navarrete-Rodríguez EM, Larenas-Linnemann D, Vidaurri de la Cruz H, Luna-Pech JA, Guevara Sanginés E. Oral Janus Kinase Inhibitors in Pediatric Atopic Dermatitis. Curr Allergy Asthma Rep 2024; 24:485-496. [PMID: 39105881 DOI: 10.1007/s11882-024-01167-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2024] [Indexed: 08/07/2024]
Abstract
PURPOSE OF REVIEW To analyze the efficacy and safety of Janus kinase inhibitors (JAKi) in the treatment of pediatric AD. RECENT FINDINGS Adolescents with moderate and severe atopic dermatitis (AD) need systemic therapies, as stated several recent practice guidelines. (JAKi) have shown their efficacy in the treatment of adult AD, however, there is a lack of information concerning efficacy and safety of their use in pediatric AD. We found that the JAKi's abrocitinib (ABRO), baricitinib (BARI), and upadacitinib (UPA), are all an effective treatment option with a very fast onset of action for adolescents with moderate-to-severe AD. BARI was not effective in children between 2 and 10 years with moderate-to-severe AD. Fortunately, major safety issues with JAKi in adolescents with AD have not been documented in the trials, so far, contrasting with the reports in adults with AD, where these events have very rarely occurred. There are some reports of herpes zoster (HZ) infection in adolescents on JAKi, but it is not a major safety concern. Acne is a relatively common AE with UPA in adolescents; however, it is responsive to standard treatment. This review will help the clinician to choose among the JAKi according to the needs and clinical features of patients with moderate and severe AD. In the following years, with the advent of new biologicals and JAKi, these therapies will fall into place in each phase of the evolution of patients with AD.
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Affiliation(s)
| | - Désirée Larenas-Linnemann
- Centro de Excelencia en Asma y Alergia Larenas, Hospital Médica Sur, Mexico City, Mexico.
- Dermatology Department, Hospital Regional "Lic. Adolfo López Mateos" ISSSTE, Mexico City, Mexico.
| | | | - Jorge A Luna-Pech
- Pediatric Dermatology Department, Hospital General de México Dr. Eduardo Liceaga Health Ministry, Mexico City, Mexico
| | - Esther Guevara Sanginés
- Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Mexico
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Patruno C, Lauletta G, Pezzolo E, Boccaletti V, Rossi M, Caroppo F, Fortina AB, Russo F, Cocuroccia B, Bello GD, Martora F, di Vico F, Napolitano M. Effectiveness and Safety of Upadacitinib for Adolescents with Atopic Dermatitis in a Real-World Setting. Clin Drug Investig 2024; 44:629-634. [PMID: 39012535 DOI: 10.1007/s40261-024-01382-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2024] [Indexed: 07/17/2024]
Abstract
BACKGROUND AND OBJECTIVE The estimated prevalence of atopic dermatitis (AD) among adolescents (12-17 years of age) is about 14.8%. AD compromises sleep quality and may be associated with poor scholastic performance, mood disruptions, low self-esteem, and difficulty in building social relationships. Upadacitinib was recently approved by the European Medicines Agency for the treatment of moderate-to-severe AD in patients aged ≥ 12 years who are candidates for systemic treatment. The aim of this real-world study was to determine the effectiveness in disease control and safety of upadacitinib in adolescents aged 12-17 years with moderate-to-severe AD. METHODS This is a retrospective study in adolescents with moderate-to-severe AD treated with upadacitinib 15 mg between July 2022 and February 2024 at six Italian dermatological referral centres. The primary endpoint was to analyse the evolution of the response in terms of absolute Eczema Area and Severity Index (EASI) value, as well as the percentage of patients achieving 75% and 90% improvement in EASI (EASI75 and EASI90) from baseline to weeks (W) 4, 16, 24, and 52. Secondary endpoints included the assessment of treatment efficacy in terms of Numerical Rating Scale (NRS) for pruritus (P-NRS) and sleep (S-NRS), Children's Dermatology Life Quality Index (c-DLQI), and safety. RESULTS Thirty-six patients [males: 18 (50%)] were evaluated. A statistically significant improvement of EASI was observed at each timepoint, as stated by a mean percentage reduction from baseline of 72.2% at W4, 82.7% at W16, of 86.4% at W24 (n = 34) and of 92.7% at W52 (n = 18) (p < 0.0001). At W4, 21/36 (58.3%) achieved EASI75 and 12/36 (33.3%) EASI90. At W16, 29/36 (80.5%) achieved EASI75 and 19/36 (52.8%) EASI90. At W24, 32/34 (94.1%) reached EASI75 and 24/34 (70.6%) EASI90. Finally, at W52 all the assessed patients (n = 18) maintained EASI75 and 14/18 (77.7%) reached EASI90. Likewise, a statistically significant reduction of c-DLQI, P-NRS and S-NRS was observed at each timepoint. CONCLUSION Our real-world experience seems to confirm the efficacy and safety of upadacitinib for the long-term treatment of moderate-to-severe AD in adolescents.
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Affiliation(s)
- Cataldo Patruno
- Section of Dermatology, Health Sciences Department, Magna Graecia University, Catanzaro, Italy
| | - Giuseppe Lauletta
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
| | - Elena Pezzolo
- Department of Dermatology, San Bortolo Hospital, Vicenza, Italy
| | - Valeria Boccaletti
- Section of Dermatology, Department of Medicine, University of Brescia, Brescia, Italy
| | - Mariateresa Rossi
- Section of Dermatology, Department of Medicine, University of Brescia, Brescia, Italy
| | - Francesca Caroppo
- Dermatology Unit, Department of Medicine DIMED, University of Padua, Padua, Italy
- Department of Women and Children's Health (SDB), Pediatric Dermatology Regional Center, University of Padua, Padua, Italy
| | - Anna Belloni Fortina
- Department of Women and Children's Health (SDB), Pediatric Dermatology Regional Center, University of Padua, Padua, Italy
| | - Filomena Russo
- Dermatological Department, Istituto Dermopatico dell'Immacolata, IRCCS, Rome, Italy
| | - Barbara Cocuroccia
- Dermatological Department, Istituto Dermopatico dell'Immacolata, IRCCS, Rome, Italy
| | - Giacomo Dal Bello
- Section of Dermatology, Department of Medicine, ASST di Mantova, Mantova, Italy
| | - Fabrizio Martora
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Francesca di Vico
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
| | - Maddalena Napolitano
- Section of Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy
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10
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Hagino T, Hamada R, Yoshida M, Saeki H, Fujimoto E, Kanda N. 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. Clin Drug Investig 2024; 44:261-269. [PMID: 38446396 DOI: 10.1007/s40261-024-01352-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/25/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Atopic dermatitis is characterized by persistent eczema and pruritus. Janus kinase inhibitors, including upadacitinib, are effective treatments for moderate-to-severe atopic dermatitis. If patients do not respond well to a certain dose of a Janus kinase inhibitor, increasing the dose may improve their treatment responsiveness. OBJECTIVES We assessed the outcomes of a dose increase in upadacitinib from 15 mg to 30 mg for Japanese patients with moderate-to-severe atopic dermatitis. METHODS In 23 patients who showed insufficient responses to upadacitinib 15-mg treatment, the dose of upadacitinib was increased to 30 mg. We evaluated total Eczema Area and Severity Index (EASI), EASI on the head and neck, trunk, upper, or lower limbs, EASI of erythema, edema/papulation, excoriation, or lichenification, and Peak Pruritus Numerical-Rating Scale at baseline (onset of upadactinib 15 mg), week 0 (time of increase), and weeks 4 and 12 after the increase. RESULTS Total EASI, EASI on each anatomical site, EASI of each clinical sign, and Peak Pruritus Numerical-Rating Scale were markedly reduced at weeks 4 or 12 compared with week 0. After the dose increase, the achievement rates of EASI 75 and EASI 90 significantly improved; EASI 75 4.3%, 68.2%, and 66.7%; EASI 90 0%, 18.2%, and 38.1% at weeks 0, 4, and 12, respectively. CONCLUSIONS These results suggest that upadacitinib 30 mg can ameliorate rash and pruritus insufficiently improved by upadacitinib 15 mg, and that the dose increase to 30 mg may be considered as a treatment option for patients with atopic dermatitis with a limited response to upadacitinib 15 mg.
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Affiliation(s)
- Teppei Hagino
- Department of Dermatology, Nippon Medical School, Chiba Hokusoh Hospital, Kamagari 1715, Inzai, Chiba, 270-1694, Japan.
| | - Risa Hamada
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Mai Yoshida
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | - Hidehisa Saeki
- Department of Dermatology, Nippon Medical School, Tokyo, Japan
| | | | - Naoko Kanda
- Department of Dermatology, Nippon Medical School, Chiba Hokusoh Hospital, Kamagari 1715, Inzai, Chiba, 270-1694, Japan
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Ibba L, Gargiulo L, Vignoli CA, Fiorillo G, Valenti M, Costanzo A, Narcisi A. Practical Use of Upadacitinib in Patients with Severe Atopic Dermatitis in a Real-World Setting: A Systematic Review. Clin Cosmet Investig Dermatol 2024; 17:593-604. [PMID: 38495913 PMCID: PMC10944248 DOI: 10.2147/ccid.s329442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 02/24/2024] [Indexed: 03/19/2024]
Abstract
Upadacitinib is a selective Janus kinase inhibitor approved for the treatment of severe atopic dermatitis (AD). This systematic review aims to summarize the most recent data in terms of effectiveness and safety of upadacitinib in the treatment of severe AD in a real-world setting. The review included a comprehensive search of databases, including PubMed, Google Scholar and Web of Science, according to Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines. The literature search initially identified 242 studies. Of these, 214 were excluded after reviewing their titles and abstracts. We then conducted a full-text review of 25 studies, of which 17 met our inclusion criteria and were therefore included in our systematic review. The analysis of real-world studies showed high effectiveness of upadacitinib, in terms of both clinical signs and subjective symptoms, in different patient populations, including those resistant to other treatments. No new significant safety concerns have emerged as compared to randomized clinical trials.
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Affiliation(s)
- Luciano Ibba
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Luigi Gargiulo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Carlo Alberto Vignoli
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Giovanni Fiorillo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Mario Valenti
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - Antonio Costanzo
- Dermatology Unit, IRCCS Humanitas Research Hospital, Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Milan, Italy
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Zhao J, Liang S, Zhou B, Li M, Li L. A Comprehensive Analysis of Immunoglobulin E Levels, Allergen-Specific Sensitivities, and Clinical Manifestations in Allergic Dermatological Conditions: A Multicenter Retrospective Study in China. Clin Cosmet Investig Dermatol 2024; 17:499-512. [PMID: 38444403 PMCID: PMC10913895 DOI: 10.2147/ccid.s451117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/08/2024] [Indexed: 03/07/2024]
Abstract
Objective To assess the correlations between Immunoglobulin E (IgE) levels, pruritus, and lesion severity in patients with eczema, atopic dermatitis, or urticaria. Methods A retrospective study was conducted and data of 814 patients who visited the dermatology or allergy clinics of multiple hospitals, from December 2019 to December 2021, were collected. Patients were divided into children group (<18 years, 325 cases), adult group (18-60 years, 435 cases), and older population group (>60 years, 54 cases) based on the age. Baseline information, pruritus severity, severity of skin lesions, total IgE level, and specific IgE level were recorded to analyze the complex relationship between them. Results The prevalence of allergic conjunctivitis and allergic rhinitis in the children group was significantly higher than that in the adult and older population group (P < 0.01 or P < 0.05). The positive rate of specific IgE in children group was significantly higher than that in the adult and older population group (P < 0.01). The IgE levels in children with moderate pruritus were significantly lower than those of severe pruritus (63.39vs 114.42 IU/mL, P < 0.05). The IgE levels in children with mild and moderate skin lesions were significantly lower than those in children with severe skin lesions (58.95 vs 72.88 vs 169.15 IU/mL, P < 0.001 or P < 0.01, respectively). Conclusion Relationships among age, severity of skin pruritus and lesions, and allergen-specific IgE response are complex and subtle, displaying dynamic patterns.
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Affiliation(s)
- Jian Zhao
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Surong Liang
- Beijing Luhe Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Boyang Zhou
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Min Li
- Clinical Epidemiology and Evidence Based Medicine Unit, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China
| | - Linfeng Li
- Department of Dermatology, Beijing Friendship Hospital, Capital Medical University, Beijing, People’s Republic of China
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