Use of Upadacitinib to Treat Atopic Dermatitis Refractory to Dupilumab in Elderly Patients

M. Hren, S. Khattri
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Abstract

Atopic dermatitis (AD) is a relapsing and remitting inflammatory skin disease that can significantly impair an individual’s quality of life. Elderly-onset AD is increasing in prevalence in developed countries, likely due to aging populations. When disease is refractory to both topical steroids and dupilumab (a systemic IL-4R α inhibitor), there remains a lack of guidelines for treatment in elderly populations. Herein, we describe the treatment of five elderly patients (≥ 65-years-old) with upadacitinib, a novel JAK-inhibitor that is rarely used in elderly patients due to the elevated risk of systemic side effects. In this report, we found that upadacitinib successfully treated these patients’ atopic dermatitis, with minimal adverse effects. Presently, all five patients continue with this treatment.
用乌达帕替尼治疗老年患者对杜匹单抗难治的特应性皮炎
特应性皮炎(AD)是一种复发性和缓解性炎症性皮肤病,会严重影响患者的生活质量。在发达国家,老年特应性皮炎的发病率越来越高,这可能是由于人口老龄化所致。当局部类固醇激素和杜必鲁单抗(一种全身用 IL-4R α 抑制剂)均难治时,仍缺乏针对老年人群的治疗指南。在此,我们介绍了用达达替尼治疗五名老年患者(≥ 65 岁)的情况,达达替尼是一种新型 JAK 抑制剂,由于全身副作用风险较高,很少用于老年患者。在本报告中,我们发现达达替尼成功治疗了这些患者的特应性皮炎,且不良反应极小。目前,所有五名患者都在继续接受这种治疗。
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