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

Abstract

Background

Upadacitinib is an oral Janus kinase (JAK) 1 inhibitor approved in Japan for moderate-to-severe atopic dermatitis (AD), and it provides a high therapeutic efficacy.

Objectives

We compared the therapeutic effects of upadacitinib on skin rashes of individual anatomical sites, head and neck, upper limbs, lower limbs, and trunk in patients with AD.

Methods

From August 2021 to December 2022, 65 Japanese patients with moderate-to-severe AD (aged ≥ 12 years) were treated with oral once daily upadacitinib 15 mg plus twice daily topical corticosteroids of moderate-to-strongest classes.

Results

The eczema area and severity indexes (EASIs) of individual sites decreased significantly at weeks 4, 12, and 24 compared to those at week 0 in parallel to total (whole body) EASI. The achievement rates of EASI 75 at week 24 and of EASI 90 at week 12 of lower limbs were significantly higher than those of trunk. The percent reductions of EASI of lower limbs at weeks 12 and 24 were significantly higher than those of head and neck and of trunk.

Conclusions

Among the four anatomical sites, the treatment responsiveness to upadacitinib in lower limbs appeared the highest, while those in trunk and in head and neck appeared relatively lower.

Keywords:

• Atopic dermatitis
• upadacitinib
• Janus kinase
• eczema area and severity index
• lower limb
• head and neck
• trunk

Ethical approval

The study was conducted in accordance with the Declaration of Helsinki, and approved by the Ethics Committee of Nippon Medical School Chiba Hokusoh Hospital (protocol code H-2022-945 and February 10, 2022 of approval).

Author contributions

Teppei Hagino mainly organized the manuscript, and Naoko Kanda, Eita Fujimoto, and Hidehisa Saeki revised it. All authors have read and agreed to the published version of the manuscript.

Disclosure statement

H. S. received a lecture fee and research cost from AbbVie GK. T. H. and N. K. received lecture fees from AbbVie GK.

Data availability statement

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Additional information

Funding

This research received no external funding.