PharmatecaPharmatecaФарматека2073-40342414-9128Bionika Media69373610.18565/pharmateca.2025.7.62-68ReviewsОбзорыReview ArticleNew treatment options for severe atopic dermatitis: upadacitinib. ReviewНовые возможности лечения тяжелого атопического дерматита: упадацитиниб. Обзорhttps://orcid.org/0000-0001-5999-7085MacharadzeDali S.МачарадзеДали Шотаевна
Russian Federation

Dr. Sci. (Med.), Leading Researcher, Clinical Department

д.м.н., ведущий науч. сотр. клинического отдела

nzayceva@bionika-media.ruGabrichevsky Moscow Research Institute of Epidemiology and MicrobiologyМосковский научно-исследовательский институт эпидемиологии и микробиологии им. Г.Н. Габричевского0711202532762681810202518102025Copyright ©; 2025, Bionika MediaCopyright ©; 2025, ООО «Бионика Медиа»2025Bionika MediaООО «Бионика Медиа»https://journals.eco-vector.com/2073-4034/article/view/693736

Treatment of atopic dermatitis (AD) is based on the use of topical anti-inflammatory agents, and in cases of moderate and severe course – systemic drugs. The latter include glucocorticosteroids and classical immunosuppressants (cyclosporine A, methotrexate, azathioprine), which have many side effects and are poorly tolerated. Since 2017, the monoclonal antibody dupilumab (biological therapy) has been approved for the treatment of AD in adults and children (including those aged 6 months), and since 2021 – Janus kinase inhibitors (small molecules, or molecular therapy). Small molecule inhibitor research began over 50 years ago in the world’s leading pharmaceutical companies and was aimed at developing drugs that affect cytokine receptor signaling and regulation of the JAK/STAT response. This review describes the efficacy and safety of treating AD with upadacitinib, a selective, fast-acting JAK1 kinase inhibitor that significantly reduces itching and other clinical symptoms in patients with this difficult-to-treat disease as early as day 2 after administration. Upadacitinib is a systemic immunomodulator, the use of which will undoubtedly expand the available treatment options for moderate to severe AD in children and adults and, due to its modifying effect, represents an alternative to other systemic drugs.

Лечение атопического дерматита (АтД) основано на использовании наружных противовоспалительных средств, а в случаях среднего и тяжелого течения – системных препаратов. К числу последних относят глюкокортикостероиды и классические иммуносупрессанты (циклоспорин А, метотрексат, азатиоприн), которые обладают многими побочными эффектами и плохой переносимостью. С 2017 г. в лечении АтД у взрослых и детей (в т.ч. с 6-месячного возраста) одобрено применение моноклонального антитела дупилумаба (биологическая терапия), а с 2021 г. – ингибиторов янускиназы (малые молекулы, или молекулярная терапия). Исследования ингибиторов малых молекул начаты более 50 лет назад в ведущих фармацевтических компаниях мира и были нацелены на разработку лекарств, влияющих на передачу сигналов от рецепторов цитокинов и регуляцию JAK/STAT-ответа. В этом обзоре описаны эффективность и безопасность лечения АтД упадацитинибом – селективным быстродействующим ингибитором киназы JAK1, который уже на 2-й день после приема способствует значительному снижению зуда кожи и других клинических симптомов у пациентов с трудноизлечиваемым заболеванием. Упадацитиниб – системный иммуномодулятор, использование которого, несомненно, позволит расширить доступные варианты лечения АтД средней и тяжелой степеней у детей и взрослых и за счет модифицирующего действия представляет альтернативу другим системным препаратам.

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