New treatment options for severe atopic dermatitis: upadacitinib. Review

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Abstract

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.

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Dali S. Macharadze

Gabrichevsky Moscow Research Institute of Epidemiology and Microbiology

Author for correspondence.
Email: nzayceva@bionika-media.ru
ORCID iD: 0000-0001-5999-7085

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

Russian Federation, Moscow

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2. Figure. Skin lesions in a patient with atopic dermatits: a - in a mammary gland area, b - on the extremities

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