Effectiveness of switching from baricitinib 4 mg to upadacitinib 30 mg in patients with moderate-to-severe atopic dermatitis: a real-world clinical practice in Japan

Figures & data

Table 1. Demographics and baseline characteristics of patients with atopic dermatitis (n = 20).

Male sex, n (%)		16 (80)
Age (years)^a		44.1 ± 12.8
< 18 years, n (%)		2 (10)
Body mass index (kg/m²)^a		24.4 ± 3.9
Disease duration (years)^a		38.4 ± 11.3
Clinical indexes
Total EASI^a		26.3 ± 10.0
EASI at face and neck^a		3.1 ± 1.6
EASI at upper limbs^b		5.4 [4.2–6.4]
EASI at lower limbs^b		7.8 [6.0–10.5]
EASI at trunk^a		9.3 ± 3.8
EASI of erythema		4.4 [3.7–6.9]
EASI of edema/papulation		6.3 [5.7–7.8]
EASI of excoriation		6.6 [5.8–9.0]
EASI of lichenification		6.9 [4.9–8.8]
PP-NRS^b		8 [6.8–10]
Laboratory parameters
IgE (IU/mL)^b		5624 [758.5–13863]
TARC (pg/mL)^b		2790.5 [1820.3–4904.8]
LDH (IU/mL)^b		280.5 [241.5–365.3]
TEC (/mL)^b		434.4 [360.2–754.5]
Reasons for switching, n (%)
EASI ≥ 16 or head and neck EASI ≥ 2.4	6 (30)
PP-NRS ≥ 4	1 (5)
Impaired QOL	9 (45)
Adverse events	4 (20)

^a Data provided as the mean ± standard deviation.

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

EASI: eczema area and severity index; PP-NRS: peak pruritus-numerical rating score; IgE: immunoglobulin E; TARC: thymus and activation-regulated chemokine; LDH: lactate dehydrogenase; TEC: total eosinophil count; QOL, quality of life.

Figure 1. The improvement of total EASI (a) and PP-NRS (b) after switching from baricitinib 4 mg to upadacitinib 30 mg in patients with atopic dermatitis (n = 20). (c) percent reductions of total EASI and PP-NRS from baseline. The data are shown as median [interquartile]. **p < 0.01 versus values at baseline; ^†p < 0.05, ^††p < 0.01 versus values at week 0, by friedman’s test with Bonferroni post-hoc test.

Figure 2. The achievement rates of EASI 75, EASI 90, and PP-NRS 4 at week 0, 4 and 12 after switching from baricitinib 4 mg to upadacitinib 30 mg in patients with atopic dermatitis (n = 20). ^†p < 0.05, ^††p < 0.01 versus values at week 0, by Fisher’s exact test.

Figure 3. The improvement of EASI scores at head and neck (a), upper limbs (b), lower limbs (c), and trunk (d) after switching from baricitinib 4 mg to upadacitinib 30 mg in patients with atopic dermatitis (n = 20). the data are shown as median [interquartile range]. *p < 0.05, **p < 0.01 versus values at baseline; ^†p < 0.05, ^††p < 0.01 versus values at week 0, by friedman’s test with Bonferroni post-hoc test.

Figure 4. Percent reductions from baseline in EASI scores on head and neck, upper limbs, lower limbs, and trunk at week 0, 4 and 12 after switching from baricitinib 4 mg to upadacitinib 30 mg in patients with atopic dermatitis (n = 20). data are presented as median [interquartile range]. ^†p < 0.05, ^††p < 0.01 versus values at week 0, by friedman’s test with Bonferroni post-hoc test.

Figure 5. The improvement of EASI scores of erythema (a), edema/papulation (b), excoriation (c), or lichenification (d) after switching from baricitinib 4 mg to upadacitinib 30 mg in patients with atopic dermatitis (n = 20). the data are shown as median [interquartile range]. *, p < 0.05, **p < 0.01 versus values at baseline; ^†p < 0.05, ^††p < 0.01 versus values at week 0, by friedman’s test with Bonferroni post-hoc test.

Figure 6. Percent reductions from baseline in EASI scores of erythema, edema/papulation, excoriation, and lichenification at week 0, 4 and 12 after switching from baricitinib 4 mg to upadacitinib 30 mg in patients with atopic dermatitis (n = 20). data are presented as median [interquartile range]. ^†p < 0.05, ^††p < 0.01 versus values at week 0; ^§p < 0.05, versus values at week 4, by friedman’s test with Bonferroni post-hoc test.

Figure 7. The transition of total eosinophil count (TEC) (a), LDH (b), TARC (c) and IgE (d) after switching from baricitinib 4 mg to upadacitinib 30 mg in patients with atopic dermatitis (n = 20). the data are shown as median [interquartile range]. *p < 0.05 versus values at baseline; ^†p < 0.05, ^††p < 0.01 versus values at week 0; ^§p < 0.05, versus values at week 4, by Friedman’s test with Bonferroni post-hoc test.

Table 2. Treatment-emergent adverse events (TEAEs) during treatment with baricitinib 4 mg or after switching to upadacitinib 30 mg in patients with atopic dermatitis (n = 20).

	During treatment with baricitinib	After switching to upadacitinib
TEAE	n (%)
All TEAEs	16 (80)	10 (50)
Serious AE	0 (0)	0 (0)
AE leading to discontinuation of treatment	4 (20)	0 (0)
AE leading to death	0 (0)	0 (0)
AEs of special interest
Acne	3 (15)	0 (0)
Elevation of creatinine phosphokinase	2 (10)	4 (20)
Cellulitis	0 (0)	1 (5)
Herpes labialis	2 (10)	2 (10)
Herpes zoster	0 (0)	3 (15)
Renal impairment	4 (20)	0 (0)
Atopic dermatitis	2 (10)	0 (0)
Headache	1 (5)	0 (0)
Nausea	2 (10)	0 (0)
AE, adverse event

Data availability statement

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