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

Figures & data

Table 1. Demographics and baseline characteristics of patients with atopic dermatitis.

Sex, n (%)
Male	46 (70.77)
Female	19 (29.23)
Age (years)^a	34 [15–50]
Age group, n (%)
<18 years	21 (32.31)
≧18 years	44 (67.69)
Body mass index (kg/m²)^b	23.74 ± 4.1
Disease duration (years)^a	20 [13–40]
Prior usage of dupilumab	10 (15.38)
Clinical indexes
Total EASI^a	20.4 [16.6–32]
EASI of head and neck^b	2.95 ± 1.8
EASI of upper limbs^b	4.94 ± 2.6
EASI of lower limbs^b	8.25 ± 4.18
EASI of trunk^b	7.07 ± 3.4
Laboratory parameters
IgE (IU/mL)^a	3058 [586–8911]
TARC (pg/mL)^a	1214 [596–3240]
LDH (IU/mL)^a	248 [199–314]
TEC (/mL)^a	451 [272.6–704]

EASI: eczema area and severity index; IgE: immunoglobulin E; TARC: thymus and activation-regulated chemokine; LDH: lactate dehydrogenase; TEC: total eosinophil count.

^a Data provided as the median [interquartile range].

^b Data provided as the mean ± standard deviation.

Table 2. Correlation between baseline background factors and eczema area and severity index for each anatomical site.

Background factors	Total EASI			EASI of head and neck			EASI of upper limbs			EASI of lower limbs			EASI of trunk
Sex (n)	Male (46)	Female (19)	p	Male (46)	Female (19)	p	Male (46)	Female (19)	p	Male (46)	Female (19)	p	Male (46)	Female (19)	p
	21.15 [16.7–30.63]^a	18.4 [16.15–34.85]^a	.98	3.2 [1.5–4.25]^a	2.8 [1–4.4]^a	.63	4.35 [3–6.4]^a	5.6 [3.6–8]^a	.24	8.4 [5.7–11.8]^a	8.4 [5.6–10.8]^a	.96	7.2 [4.58–8.85]^a	7.2 [5.4–10.5]^a	.48
Prior treatment with dupilumab (n)	Absence (55)	Presence (10)	p	Absence (55)	Presence (10)	p	Absence (55)	Presence (10)	p	Absence (55)	Presence (10)	p	Absence (55)	Presence (10)	p
	23.8 [17.7–32.55]^a	8.1 [6.89–12.23]^a	1.73 × 10^–6**	3.4 [2.2–4]^a	3.0 [1.2–4.5]^a	.98	5.4 [3.8–7.1]^a	0.7 [0.55–1.4]^a	9.27 × 10^–6**	8.4 [6–12.4]^a	1.2 [0.4–3.7]^a	1.6 × 10^–5**	7.2 [5.7–9.9]^a	2.1 [1.65–3.9]^a	2.91 × 10^–4**
	Rho	p		Rho	p		Rho	p		Rho	p		Rho	p
Age	0.094	.46		–0.17	.19		–0.034	.8		0.071	.59		0.142	.28
Body mass index (kg/m²)	0.2	.12		0.024	.86		–0.016	.91		0.17	.22		0.039	.78
Disease duration	0.14	.26		–0.069	.6		–0.0066	.96		0.11	.41		0	1.0
IgE (IU/mL)	0.42	4.44 × 10^–4**		0.54	7.47 × 10^–6**		0.43	8.01 × 10^–4**		0.26	.048*		0.28	.035*
TARC (pg/mL)	0.74	2.67 × 10^–12**		0.33	.011*		0.67	8.15 × 10^–9**		0.63	1.12 × 10^–7**		0.75	1.37 × 10^–11**
LDH (IU/mL)	0.7	1.24 × 10^–12**		0.35	.0067**		0.51	3.55 × 10^–5**		0.5	5.44 × 10^–5**		0.68	3.73 × 10^–9**
TEC (/mL)	0.35	.0047**		0.26	.048*		0.22	.093		0.21	.12		0.43	5.89 × 10^–4**

EASI: eczema area and severity index; IgE: immunoglobulin E; TARC: thymus and activation-regulated chemokine; LDH: lactate dehydrogenase; TEC: total eosinophil count.

* Statistically significant at p < .05.

** Statistically significant at p < .01.

^a Data provided as the median [interquartile range], analyzed by Mann–Whitney’s U-test. Correlations between variables were examined using Spearman’s correlation coefficients.

Figure 1. The transition of total eczema area and severity index (EASI) and EASIs of individual sites (a), medians of percent reduction of EASI (b), achievement rates of EASI 75 (c), EASI 90 (d), and EASI 100 (e) at weeks 0, 4, 12, or 24 of treatment with upadacitinib plus topical corticosteroids in patients with atopic dermatitis (n = 65). *p < .05 between trunk versus lower limbs and ^†p < .05 between head and neck versus lower limbs, analyzed by Friedman’s test in (b) or by Fisher’s exact test in (c, d).

Table 3. The relations of patients’ background factors with percent reduction of EASI of head of and neck at weeks 4, 12, or 24 of upadacitinib treatment in patients with atopic dermatitis (n = 65).

Background factors	Percent reduction of EASI of head of and neck at week 4			Percent reduction of EASI of head and neck at week 12			Percent reduction of EASI of head and neck at week 24
Sex (n)	Male (46)	Female (19)	p	Male (46)	Female (19)	p	Male (46)	Female (19)	p
	70.9 [47.2–85.2]^a	80 [65.85–94]^a	.28	75 [33.33–92.13]^a	75 [61.88–93.39]^a	.73	90.28 [55.73–99.31]^a	79.67 [74.43–100]^a	.79
Prior usage of dupilumab (n)	Absence (55)	Presence (10)	p	Absence (55)	Presence (10)	p	Absence (55)	Presence (10)	p
	71.43 [52.77–86.36]^a	82 [71.13–88.13]^a	.39	75 [35.42–91.07]^a	89.38 [69.2–95.83]^a	.25	85 [61.67–100]^a	89.75 [44.55–94.38]^a	.66
	Rho	p		Rho	p		Rho	p
Age	0.022	.091		0.28	.034*		0.024	.86
Body mass index (kg/m²)	0.016	.91		–0.04	.77		–0.31	.022*
Disease duration	0.25	.054		0.25	.062		–0.028	.83
IgE (IU/mL)	–0.17	.19		–0.13	.32		–0.22	.1
TARC (pg/mL)	–0.09	.5		–0.082	.54		0.013	.92
LDH (IU/mL)	0.28	.031*		0.17	.2		–0.06	.66
TEC (/mL)	0.15	.27		0.14	.3		–0.07	.6

EASI: eczema area and severity index; IgE: immunoglobulin E; TARC: thymus and activation-regulated chemokine; LDH: lactate dehydrogenase; TEC: total eosinophil count.

* Statistically significant at p < .05.

^a Data provided as the median [interquartile range], analyzed by Mann–Whitney’s U-test. Correlations between variables were examined using Spearman’s correlation coefficients.

Table 4. The relations of patients’ background factors with percent reduction of EASI of upper limbs at weeks 4, 12, or 24 of upadacitinib treatment in patients with atopic dermatitis (n = 65).

Background factors	Percent reduction of EASI of upper limbs at week 4			Percent reduction of EASI of upper limbs at week 12			Percent reduction of EASI of upper limbs at week 24
Sex (n)	Male (46)	Female (19)	p	Male (46)	Female (19)	p	Male (46)	Female (19)	p
	78.17 [66.67–83.21]^a	85 [75–93.33]^a	.066	75 [57.14–92.5]^a	80.91 [64.72–91.25]^a	.78	83.33 [61.11–92.62]^a	88.89 [76.46–95.1]^a	.42
Prior usage of dupilumab (n)	Absence (55)	Presence (10)	p	Absence (55)	Presence (10)	p	Absence (55)	Presence (10)	p
	80 [70.71–85.19]^a	70.83 [30–100]^a	.79	80 [62.5–90]^a	87.5 [–50 to 100]^a	.85	83.33 [68.33–92.59]^a	95 [–20.83 to 100]^a	.58
	Rho	p		Rho	p		Rho	p
Age	0.17	.19		0.13	.32		0.035	.81
Body mass index (kg/m²)	–0.044	.75		0.048	.73		–0.012	.94
Disease duration	0.05	.71		0.083	.53		0.061	.69
IgE (IU/mL)	–0.29	.026*		–0.3	.02*		–0.22	.14
TARC (pg/mL)	0.027	.84		0.027	.84		0.052	.73
LDH (IU/mL)	0.013	.92		0.11	.42		0.15	.31
TEC (/mL)	0.15	.25		–0.061	.65		–0.012	.94

EASI: eczema area and severity index; IgE: immunoglobulin E; TARC: thymus and activation-regulated chemokine; LDH: lactate dehydrogenase; TEC: total eosinophil count.

* Statistically significant at p < .05.

^a Data provided as the median [interquartile range], analyzed by Mann–Whitney’s U-test. Correlations between variables were examined using Spearman’s correlation coefficients.

Table 5. The relations of patients’ background factors with percent reduction of EASI of lower limbs at weeks 4, 12, or 24 of upadacitinib treatment in patients with atopic dermatitis (n = 65).

Background factors	Percent reduction of EASI of lower limbs at week 4			Percent reduction of EASI of lower limbs at week 12			Percent reduction of EASI of lower limbs at week 24
Sex (n)	Male (46)	Female (19)	p	Male (46)	Female (19)	p	Male (46)	Female (19)	p
	75 [63.64–83.33]^a	87.88 [80–95.83]^a	.0099**	87.5 [70–94.4]^a	87.5 [71.43–92.59]^a	.87	92.13 [78.33–96.97]^a	88.99 [82.5–97.73]^a	.95
Prior usage of dupilumab (n)	Absence (55)	Presence (10)	p	Absence (55)	Presence (10)	p	Absence (55)	Presence (10)	p
	77.78 [66.67–89.77]^a	100 [75–100]^a	.081	86.67 [68.33–92.59]^a	100 [87.5–100]^a	.041*	90 [78.89–95.71]^a	100 [85.83–100]^a	.24
	Rho	p		Rho	p		Rho	p
Age	0.25	.057		0.19	.16		0.62	4.14 × 10^–6**
Body mass index (kg/m²)	0.074	.59		0.19	.17		0.06	.69
Disease duration	0.21	.11		0.2	.14		0.46	.0015**
IgE (IU/mL)	–0.42	.0011**		–0.27	.04*		–0.25	.098
TARC (pg/mL)	–0.28	.034*		–0.25	.056		–0.041	.79
LDH (IU/mL)	–0.1	.5		0.011	.94		0.012	.94
TEC (/mL)	0.17	.21		–0.086	.52		0.13	.4

EASI: eczema area and severity index; IgE: immunoglobulin E; TARC: thymus and activation-regulated chemokine; LDH: lactate dehydrogenase; TEC: total eosinophil count.

* Statistically significant at p < .05.

** Statistically significant at p < .01.

^a Data provided as the median [interquartile range], analyzed by Mann–Whitney’s U-test. Correlations between variables were examined using Spearman’s correlation coefficients.

Table 6. The relations of patients’ background factors with percent reduction of EASI of trunk at weeks 4, 12, or 24 of upadacitinib treatment for patients with atopic dermatitis (n = 65).

Background factors	Percent reduction of EASI of trunk at week 4			Percent reduction of EASI of trunk at week 12			Percent reduction of EASI of trunk at week 24
Sex (n)	Male (46)	Female (19)	p	Male (46)	Female (19)	p	Male (46)	Female (19)	p
	72.73 [62.5–81.25]^a	82.86 [75–95.45]^a	.036*	66.67 [43.75–83.33]^a	65.91 [61.9–91.67]^a	.45	74.6 [55.95–91.52]^a	72.73 [64.23–86.55]^a	.74
Prior usage of dupilumab (n)	Absence (55)	Presence (10)	p	Absence (55)	Presence (10)	p	Absence (55)	Presence (10)	p
	75 [68.33–83.33]^a	75 [66.07–91.67]^a	.56	66.67 [50–86.34]^a	58.3 [46.43–71.88]^a	.45	72.73 [58.57–87.08]^a	58.33 [–8.93 to 100]^a	.79
	Rho	p		Rho	p		Rho	p
Age	0.038	.78		0.29	.025*		0.17	.27
Body mass index (kg/m²)	0.039	.78		–0.086	.53		0.033	.83
Disease duration	0	1.0		0.16	.24		0.14	.35
IgE (IU/mL)	–0.38	.0033**		–0.17	.21		–0.23	.13
TARC (pg/mL)	–0.083	.54		0.16	.23		–0.014	.93
LDH (IU/mL)	0.049	.71		0.18	.18		0.1	.5
TEC (/mL)	0.2	.13		0.18	.17		0.12	.42

EASI: eczema area and severity index; IgE: immunoglobulin E; TARC: thymus and activation-regulated chemokine; LDH: lactate dehydrogenase; TEC: total eosinophil count.

* Statistically significant at p < .05.

** Statistically significant at p < .01.

^a Data provided as the median [interquartile range], analyzed by Mann–Whitney’s U-test. Correlations between variables were examined using Spearman’s correlation coefficients.

Table 7. The predictive factors for the percent reduction of eczema area and severity index (EASI) of lower limbs at weeks 4, 12, or 24 of upadacitinib treatment assessed by linear multivariate regression analysis in patients with atopic dermatitis (n = 65).

	Percent reduction of EASI of lower limbs at week 4				Percent reduction of EASI of lower limbs at week 12				Percent reduction of EASI of lower limbs at week 24
	β coefficient	Standard error	t	p	β coefficient	Standard error	t	p	β coefficient	Standard error	t	p
Intercept	87.67	15.49	5.66	6.26 × 10^–7**	70.71	10.51	6.73	1.24 × 10^–8**	49.77	45.83	1.09	0.28
Age	0.3	0.28	1.09	.28	0.21	0.19	1.13	.26	0.74	1.31	0.57	.58
Sex [T.M]	–25.65	12.44	–2.06	.044*	0.11	8.32	0.013	.99	–18.31	37.57	–0.49	.63
Prior usage of dupilumab	NA				4.5	11.74	0.38	.7	NA
Disease duration	NA				NA				0.16	1.74	0.093	.93
IgE (IU/mL)	–0.001	7.7 × 10^–4	–1.35	.18	–4.5 × 10^–4	4.6 × 10^–4	–0.98	.33	NA
TARC (pg/mL)	–9.6 × 10^–4	0.0014	–0.7	.49	NA				NA

IgE: immunoglobulin E; TARC: thymus and activation-regulated chemokine; NA: not applicable.

* Statistically significant at p < .05.

** Statistically significant at p < .01.

Data availability statement

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