A clinical case of the use of the selective janus kinase inhibitor upadacitinib in an adult patient with severe atopic dermatitis

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Resumo

Background. Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases affecting both children and adults. Its effect on the patient largely correlates with the severity of the disease. Despite this, there is currently a high level of dissatisfaction with effective and safe systemic therapy. The immunological complexity of the pathogenesis of AD makes the suppression of Janus kinases a promising approach to treatment.

Description of the clinical case. This case report describes the successful use of upadacitinib, a selective oral Janus kinase 1 inhibitor, in a patient with severe AD. The drug demonstrated a rapid clinical response, good tolerance and ease of use. Our experience has confirmed that upadacitinib is an effective and safe treatment option for refractory forms of AD.

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Sobre autores

Elena Svechnikova

Polyclinic № 1 of the Administrative Department of the President of the Russian Federation; Russian Biotechnological University

Autor responsável pela correspondência
Email: elene-elene@bk.ru
ORCID ID: 0000-0002-5885-4872

Dr. Sci. (Med.), Head of the Department of Dermatovenereology and Cosmetology; Professor at the Department of Skin and Venereal Diseases

Rússia, Moscow; Moscow

K. Fomin

Russian Biotechnological University

Email: elene-elene@bk.ru
ORCID ID: 0000-0003-4003-8081
Rússia, Moscow

Bibliografia

  1. Debinska A. New Treatments for Atopic Dermatitis Targeting Skin Barrier Repair via the Regulation of FLG Expression. J Clin Med. 2021;10(11):2506. doi: 10.3390/jcm10112506.
  2. Feldman S.R., Cox L.S., Strowd L.C., et al. The Challenge of Managing Atopic Dermatitis in the United States. Am. Health Drug Benefits. 2019;12(2):83–93.
  3. Maspero J., De Paula Motta Rubini N., Zhang J., et al. Epidemiology of adult patients with atopic dermatitis in AWARE 1: A second international survey. World Allergy Organ J. 2023;16(3):100724. doi: 10.1016/j.waojou.2022.100724.
  4. Bieber T. Atopic dermatitis: an expanding therapeutic pipeline for a complex disease. Nat Rev Drug Discov. 2022;21(1):21–40. doi: 10.1038/s41573-021-00266-6.
  5. Moyle M., Cevikbas F., Harden J.L., Guttman-Yassky E. Understanding the immune landscape in atopic dermatitis: The era of biologics and emerging therapeutic approaches. Exp Dermatol. 2019;28(7):756–68. doi: 10.1111/exd.13911.
  6. Na C.H., Baghoomian W., Simpson E.L. A Therapeutic Renaissance – Emerging Treatments for Atopic Dermatitis. Acta Derm Venereol. 2020;100(12):adv00165. doi: 10.2340/00015555-3515.
  7. Naik P.P. Treatment-resistant atopic dermatitis: novel therapeutics, digital tools, and precision medicine. Asia Pac Allergy. 2022;12(2):e20. doi: 10.5415/apallergy.2022.12.e20.
  8. Lugovic-Mihic L., Mestroviс-Stefekov J., Potoсnjak I., et al. Atopic Dermatitis: Disease Features, Therapeutic Options, and a Multidisciplinary Approach. Life (Basel). 2023;13(6):1419. doi: 10.3390/life13061419.
  9. Rщnnstad A.T.M., Bay L., Ruge I.F., et al. Defining the temporal relationship between the skin microbiome, immune response and skin barrier function during flare and resolution of atopic dermatitis: protocol of a Danish intervention study. BMJ Open. 2023;13(2):e068395. doi: 10.1136/bmjopen-2022-068395.
  10. Brunner P.M., Guttman-Yassky E., Leung D.Y. The immunology of atopic dermatitis and its reversibility with broad-spectrum and targeted therapies. J Allergy Clin Immunol. 2017;139(4S):S65–76. doi: 10.1016/j.jaci.2017.01.011.
  11. Makowska K., Nowaczyk J., Blicharz L., et al. Immunopathogenesis of Atopic Dermatitis: Focus on Interleukins as Disease Drivers and Therapeutic Targets for Novel Treatments. Int J Mol Sci. 2023;24(1):781. doi: 10.3390/ijms24010781.
  12. Wollenberg A., Werfel T., Ring J., et al. Atopic Dermatitis in Children and Adults – Diagnosis and Treatment. Dtsch. Arztebl. Int. 2023;120(13):224–34. doi: 10.3238/arztebl.m2023.0011.
  13. Facheris P., Jeffery J., Del Duca E., Guttman-Yassky E. The translational revolution in atopic dermatitis: the paradigm shift from pathogenesis to treatment. Cell Mol Immunol. 2023;20(5):448–74. doi: 10.1038/s41423-023-00992-4.
  14. Czarnowicki T., He H., Canter T., et al. Evolution of pathologic T-cell subsets in patients with atopic dermatitis from infancy to adulthood. J Allergy Clin Immunol. 2020;145(1):215–28. doi: 10.1016/j.jaci.2019.09.031.
  15. Lytvyn Y., Mufti A., Abduelmula A., et al. Efficacy and Safety of Upadacitinib for Management of Moderate-to-Severe Atopic Dermatitis: An Evidence-Based Review. Pharmaceutics. 2022;14(11):2452. doi: 10.3390/pharmaceutics14112452.
  16. Hu X., Li J., Fu M., et al. The JAK/STAT signaling pathway: from bench to clinic. Signal Transduct Target Ther. 2021;6(1):402. doi: 10.1038/s41392-021-00791-1.
  17. Ahn J., Choi Y., Simpson E.L. Therapeutic New Era for Atopic Dermatitis: Part 2. Small Molecules. Ann. Dermatol. 2021;33(2):101–7. doi: 10.5021/ad.2021.33.2.101.
  18. Kamata M., Tada Y. Optimal Use of Jak Inhibitors and Biologics for Atopic Dermatitis on the Basis of the Current Evidence. JID Innov. 2023;3(3):100195. doi: 10.1016/j.xjidi.2023.100195.
  19. Guttman-Yassky E., Teixeira H.D., Simpson E.L., et al. Once-daily upadacitinib versus placebo in adolescents and adults with moderate-to-severe atopic dermatitis (Measure Up 1 and Measure Up 2): results from two replicate double-blind, randomised controlled phase 3 trials. Lancet. 2021;397(10290):2151–68. doi: 10.1016/S0140-6736(21)00588-2. Erratum in: Lancet. 2021 Jun 5;397(10290): 2150.
  20. Simpson E.L., Papp K.A., Blauvelt A., et al. Efficacy and Safety of Upadacitinib in Patients With Moderate to Severe Atopic Dermatitis: Analysis of Follow-up Data From the Measure Up 1 and Measure Up 2 Randomized Clinical Trials. JAMA Dermatol. 2022;158(4):404–13. doi: 10.1001/jamadermatol.2022.0029.
  21. Blauvelt A., Teixeira H.D., Simpson E.L., et al. Efficacy and Safety of Upadacitinib vs Dupilumab in Adults With Moderate-to-Severe Atopic Dermatitis: A Randomized Clinical Trial. JAMA Dermatol. 2021;157(9):1047–55. doi: 10.1001/jamadermatol.2021.3023. Erratum in: JAMA Dermatol. 2022;158(2):219.

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2. Fig.1. Clinical picture before treatment

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3. Fig.2. End of week 1 of upadacitinib

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4. Fig.3. Week 4 of upadacitinib

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