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According to this real-life retrospective analysis, upadacitinib appears to be a useful and safe treatment option for individuals with severe atopic dermatitis who have not responded well to previous systemic therapies.

Atopic dermatitis (AD) is a chronic, relapsing skin condition affecting millions worldwide. Despite the availability of various treatment options, a significant proportion of patients still struggle to achieve adequate disease control. The emergence of new systemic treatments for AD, such as biologics (treatments made from humans or other living organisms, such as bacteria or viruses) and  a category of drugs called janus kinase inhibitors, have shown promise in clinical trials. However, real-life evaluations of their efficacy and safety are essential to assess treatment outcomes in patients with different kinds of atopic dermatitis.

Upadacitinib is approved to treat moderate to severe AD in teens and adults. It works by blocking janus kinase in a specific way. A single-center study published in the journal Advances in Therapy, was conducted to assess the effectiveness of upadacitinib in adolescents and adults with severe AD who didn’t improve when treated with other systemic agents.

The study included 22 adults and 7 teens, and the average length of follow-up was 54.4 weeks. At the start of treatment with upadacitinib, the patients had severe disease and had already tried two systemic drugs without success.

Highly Effective in Real-Life Treatment of Severe Atopic Dermatitis

At the first follow-up visit between 12 to 16 weeks, 79.3% of patients achieved 58.6% improvement on one assessment scale and 75% improvement on another assessment scale for symptom severity. The study’s findings show that a slightly higher percentage of adults than adolescents achieved the effectiveness goal for the study, with disease control being better in adults (81.8%) than in adolescents (71.4%).

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Low Incidence of Adverse Events
At least one adverse event occurred in 44.8% of patients, with increased total cholesterol levels being the most frequent side effect. Other side effects included acne, low white blood cell count, and anemia were also observed. No severe adverse events were reported, and no adverse events led to treatment discontinuation.

Real-Life Evaluation of Upadacitinib

This study was the first real-life test of how well upadacitinib works and how well it is tolerated by people with severe AD who haven’t responded well to other treatments. The study’s results suggest that upadacitinib effectively controls AD symptoms. Additionally, the incidence of side effects was relatively low, with no severe adverse events reported.

Bigger, multicenter studies with longer follow-up times are needed to confirm these findings and help medical researchers learn more about how safe and effective upadacitinib is in real-life clinical settings over the long term. 


De Greef, A., Ghislain, P. D., de Montjoye, L., & Baeck, M. (2023). Real-Life Effectiveness and Tolerance of Upadacitinib for Severe Atopic Dermatitis in Adolescents and Adults. Advances in Therapy. https://doi.org/10.1007/s12325-023-02490-5