Upadacitinib for the Management of Atopic Dermatitis in Patients Aged ≥60 Years: A Long-Term Multicenter Real-World Study.
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Ippoliti Elena, Gori Niccolò, Coscarella Giulia, Ferrucci Silvia Mariel, Barei Francesca, Calabrese Laura, Lazzeri Laura, Campanati Anna, Rossi Agnese, Esposito Maria, De Berardinis Andrea, Foti Caterina, Tirone Benedetta, Galluzzo Marco, Mortato Edoardo, Antiga Emiliano, Milanesi Nicola, Girolomoni Giampiero, Maurelli Martina, Napolitano Maddalena, di Vico Francesca, Narcisi Alessandra, Bianco Matteo, Pezzolo Elena, Saboya Raul Armando Luyo, Ribero Simone, Ortoncelli Michela, Rossi Mariateresa, Bighetti Stefano, Russo Filomena, Cocuroccia Barbara, Peris Ketty
Аннотация
MATERIALS AND METHODS: We conducted a multicenter, retrospective, observational study at 15 Italian university hospitals, including patients with moderate-to-severe AD aged ≥60 years treated with upadacitinib 15 or 30 mg once daily, to evaluate the real-world effectiveness and safety of this selective JAK1 inhibitor at weeks 16, 32, 52, and 104.
RESULTS: Seventy-two patients were included (mean age 65.9 ± 6.4 years); 48/72 (66.7%) of patients showed a classical flexural phenotype; 34/72 (47.2%) presented with head-and-neck involvement. Upadacitinib led to marked and sustained improvement in both clinician-and-patient-reported outcomes, with mean Eczema Area and Severity Index decreasing from 23.9 ± 9.2 at baseline to 1.5 ± 3.0 at week 52 and 0.9 ± 2.5 at week 104. Mean itch-Numeric Rating Scales (NRS) decreased from 8.2 ± 2.0 at baseline to 1.0 ± 1.9 at week 52 and 1.0 ± 2.4 at week 104, with concomitant amelioration in sleep-NRS (6.5 ± 3.1 to 0.5 ± 1.6 and 0.3 ± 1.3) and Dermatology Life Quality Index (16.8 ± 6.9 to 1.6 ± 4.2 and 1.0 ± 3.2). Adverse events occurred in 37/72 (51,4%) patients and included dyslipidemia in 22/72 (30.6%) patients, creatine phosphokinase elevation in 15/72 (20.8%), and blood count abnormalities in 13/72 (18.1%); they were mostly mild and manageable. Overall, 16/72 patients (22.2%) discontinued treatment, including 11/72 (15.3%) due to AEs.
CONCLUSIONS: In our multicenter real-world cohort of patients aged ≥60 years, upadacitinib demonstrated rapid, sustained efficacy and an overall favorable safety profile through 104 weeks, supporting its long-term use in clinical practice with appropriate monitoring.