Upadacitinib in daily practice for refractory atopic dermatitis in adolescents: a case series of the BioDay registry

Abstract

PURPOSE: Upadacitinib is approved for treating moderate-to-severe atopic dermatitis (AD) aged ≥12 years. We evaluated upadacitinib's effectiveness and safety in AD adolescents in daily practice. MATERIALS AND METHODS: Fifteen adolescent AD patients from the BioDay registry, treated with upadacitinib 15 mg once daily were evaluated at baseline and after 4, 8, 16, and 28 weeks. Effectiveness was assessed using Eczema Area and Severity Index (EASI) score and Investigator Global Assessment (IGA) score. Patient-reported outcomes included Numeric Rating Scale (NRS) for pruritus and presence of sleep disturbance. Adverse events (AEs) were evaluated at each visit. RESULTS: Mean EASI score significantly decreased from 13.4 (95% CI 8.5-18.3) to 7.8 (95% CI 2.4-13.3) after 28 weeks (p = .002). Mean NRS pruritus significantly decreased from 6.5 (95% CI 4.9-8.2) to 4.8 (95% CI 3.0-6.6) after 28 weeks (p = .003). At week 16, 75.0% (95% CI 46.8-91.1) achieved EASI ≤7, and 50.0% (95% CI 25.4-74.6) achieved NRS pruritus ≤4. Overall, 31 AEs were reported in 10 patients (66.7%). Five patients (33.3%) discontinued treatment: two due to ineffectiveness, two due to AEs, and one due to laboratory monitoring problems. CONCLUSIONS: Our findings indicate that upadacitinib is effective and relatively safe for adolescents with moderate-to-severe AD; however, 33.3% discontinued treatment.