Treating Chronic Hand Eczema with Upadacitinib: Insights from Clinical Trials and Real-World Experience.

IF 1.8 4区 医学 Q3 DERMATOLOGY
Omar Alani, Lara Shqair, Walter J Liszewski, Henry Yu, Iyla Draw, Samer Wahood, Fabrizio Galimberti, Beth Sweney, Sabine Obagi, Andrew Mastro, Diego Dasilva, Christopher G Bunick
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引用次数: 0

Abstract

Background: Chronic hand eczema (CHE) is a chronic inflammatory skin condition that affects the hands and wrists causing itching, dryness, cracking, and pain. It often affects people with atopic dermatitis (AD) and can interfere with work and daily life. Topical therapies may have limited utility from ineffectiveness, poor adherence, or poor tolerability. Here, we evaluate oral upadacitinib (UPA) as a potential therapeutic alternative for patients with AD and refractory CHE.

Methods: This narrative review analyzed studies from PubMed, SCOPUS, and EMBASE evaluating CHE treatments. Eligible studies utilized the Hand Eczema Severity Index (HECSI), a validated clinician-reported outcome measure assessing CHE severity. HECSI-75 is the proportion of patients achieving at least a 75% improvement in clinical severity. Cases of three CHE patients from diverse demographics are presented.

Results: In two phase 3 randomized controlled trials of UPA for moderate-to-severe AD, 94.8% (803/847) and 92.6% (774/836) of patients had CHE with HECSI assessments at baseline. Rapid improvement in CHE was observed in patients who received either dose of UPA (15 mg or 30 mg) as early as week 1 (P≤0.001 vs placebo). By week 8, up to 83% of UPA-treated patients achieved a statistically significant improvement in CHE (HECSI 75; P≤0.001 vs placebo). These benefits were sustained through week 16. Real-world clinical cases showed CHE patients experienced marked symptom relief within days of initiating UPA.

Conclusion: UPA-treated patients experienced rapid and sustained relief from CHE lesions, making it a promising therapeutic option for CHE patients for whom topical therapies are ineffective.

用Upadacitinib治疗慢性手部湿疹:来自临床试验和现实世界经验的见解。
背景:慢性手部湿疹(CHE)是一种影响手部和手腕的慢性炎症性皮肤状况,引起瘙痒、干燥、开裂和疼痛。它经常影响患有特应性皮炎(AD)的人,并可能干扰工作和日常生活。局部治疗可能因无效、依从性差或耐受性差而效用有限。在这里,我们评估口服upadacitinib (UPA)作为AD和难治性CHE患者的潜在治疗选择。方法:本叙述性综述分析了PubMed、SCOPUS和EMBASE中评估CHE治疗的研究。符合条件的研究使用了手部湿疹严重程度指数(HECSI),这是一种经过验证的临床报告的评估CHE严重程度的结果指标。HECSI-75是临床严重程度改善至少75%的患者比例。病例三名患者从不同的人口统计资料提出。结果:在UPA治疗中重度AD的两项3期随机对照试验中,94.8%(803/847)和92.6%(774/836)的患者在基线时进行了HECSI评估。早在第1周接受任何剂量的UPA (15mg或30mg)的患者观察到CHE的快速改善(P&le;0.001 vs安慰剂)。到第8周,多达83%的upa治疗患者在CHE方面取得了统计学上显著的改善(HECSI 75;P&le (0.001 vs安慰剂)。这些益处持续到第16周。真实世界的临床病例显示,CHE患者在开始UPA的几天内症状明显缓解。结论:upa治疗的患者经历了快速和持续的CHE病变缓解,使其成为局部治疗无效的CHE患者的有希望的治疗选择。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
2.20
自引率
13.30%
发文量
289
审稿时长
3-6 weeks
期刊介绍: The Journal of Drugs in Dermatology (JDD) is a peer-reviewed publication indexed with MEDLINE®/PubMed® that was founded by the renowned Dr. Perry Robins MD. Founded in 2002, it offers one of the fastest routes to disseminate dermatologic information and is considered the fastest growing publication in dermatology. We present original articles, award-winning case reports, and timely features pertaining to new methods, techniques, drug therapy, and devices in dermatology that provide readers with peer reviewed content of the utmost quality. Our high standards of content are maintained through a balanced, peer-review process. Articles are reviewed by an International Editorial Board of over 160 renowned experts.
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