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Drug Evaluation

Upadacitinib for moderate to severe atopic dermatitis

    Francisco Navarro-Triviño

    Dermatology Department, Hospital Universitario San Cecilio, Avenida del Conocimiento, s/n, Granda, 18016, España

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    ,
    Sara Alcantara-Luna

    Dermatology Department, Hospital Universitario Virgen del Rocío, Avenida Manuel Siurot, s/n, Sevilla, 41013, España

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    ,
    Javier Domínguez-Cruz

    Dermatology Department, Hospital Universitario Virgen del Rocío, Avenida Manuel Siurot, s/n, Sevilla, 41013, España

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    ,
    Manuel Galán-Gutiérrez

    Dermatology Department, Hospital Universitario Reina Sofía, Avenida Menéndez Pidal, s/n, Córdoba, 14004, España

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    ,
    Ricardo Ruiz-Villaverde

    Dermatology Department, Hospital Universitario San Cecilio, Avenida del Conocimiento, s/n, Granda, 18016, España

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    ,
    José-Juan Pereyra-Rodriguez‡

    *Author for correspondence:

    E-mail Address: jpereyra@us.es

    Dermatology Department, Hospital Universitario Virgen del Rocío, Avenida Manuel Siurot, s/n, Sevilla, 41013, España

    ‡Authors contributed equally

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    &
    José-Carlos Armario-Hita‡

    Dermatology Department, Hospital Universitario de Puerto Real, Calle Romería, 7, Puerto Real, Cádiz, 11510, España

    ‡Authors contributed equally

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    Published Online:17 May 2023https://doi.org/10.2217/imt-2023-0037

    Abstract

    Atopic dermatitis is an inflammatory skin disease, the prevalence of which has increased in the last decade. It affects all age groups, with adult involvement being a major focus of interest in recent years. The unmet needs of the disease, such as pruritus, sleep quality impairment and eczematous skin lesions, have undergone a therapeutic revolution following the commercialization of drugs such as JAK inhibitors. Upadacitinib, a selective JAK1 inhibitor, has been positioned by both clinical trial results and those observed in clinical practice as the fastest and most effective drug in reducing both pruritus and Eczema Area and Severity Index and validated Investigator Global Assessment. Although the safety profile may be initially alarming, it is advisable to update the actual data in this regard for proper management. New perspectives for upadacitinib in nonatopic comorbidities such as psoriasis and alopecia areata are beginning to be described, and interest in learning more about its peculiarities is growing.

    Plain language summary

    Atopic dermatitis is the most common inflammatory skin disease. The inflammation happens when the body's defense system attacks the body's tissue. People with atopic dermatitis often have itching and red and scaly parts of the skin. The inflammation tends to be long-lasting and comes back repeatedly. The main goal of treatment is controlling the inflammation, which occurs because of a certain group of proteins called cytokines. Receptors called JAKs are involved in the inflammation that happens through cytokines, so they play an important role in this disease. A medicine called upadacitinib has been approved for the treatment of moderate to severe atopic dermatitis. In this article, you will find the most relevant published information on upadacitinib, including how effective and safe the medicine is based on both clinical studies and real-life cases.

    Tweetable abstract

    Upadacitinib 30 mg is superior to the 15-mg dose without significantly increasing the rate of adverse events or their severity. The response observed with upadacitinib at both doses, 15 and 30 mg, at 16 weeks is virtually unchanged at week 52.

    Papers of special note have been highlighted as: • of interest

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