使用upadacitinib治疗中重度特应性皮炎:患者分析,剂量选择和治疗调节,现实生活教给我们什么?

IF 3.9
Edoardo Mortato, Niccolò Gori, Giacomo Caldarola, Marina Talamonti, Claudia Paganini, Luisa Boeti, Filomena Russo, Teresa Grieco, Ersilia Tolino, Gaia Moretta, Flavia Pigliacelli, Rosa Coppola, Domenico Giordano, Camilla Chello, Concetta Potenza, Maria Concetta Fargnoli, Vincenzo Panasiti, Barbara Cocuroccia, Ketty Peris, Marco Galluzzo
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引用次数: 0

摘要

目的:这项多中心回顾性研究评估了upadacitinib在意大利中部8个中心治疗中重度特应性皮炎的有效性和安全性。材料和方法:共有150例患者接受每日15mg或30mg的upadacitinib单药治疗。使用湿疹面积和严重程度指数(EASI)、瘙痒和睡眠数值评定量表(NRS)和皮肤病生活质量指数(DLQI)评估104周的临床结果。结果:两种剂量均显著且持续改善了疾病严重程度、瘙痒、睡眠障碍和生活质量,77.8%的患者在第16周达到EASI 75, 39.2%的患者达到EASI 100。不同剂量的反应相似,尽管30毫克组的长期瘙痒控制效果更好。较高的基线EASI评分是反应的积极预测因子,而头颈部受损伤和先前的全身治疗,特别是环孢素,与较差的结果相关。安全性与先前的报道一致,痤疮样皮疹、肌酸磷酸激酶(CPK)升高和血脂异常是最常见的不良事件。未观察到特应性角膜结膜炎的再激活。结论:这些发现在临床实践中支持upadacitinib给药的有效性、安全性和灵活性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Use of upadacitinib in the treatment of moderate to severe atopic dermatitis: patient profiling, dose selection, and therapy modulation, what does real-life teach us?

Purpose: This multicenter retrospective study assessed the real-world effectiveness and safety of upadacitinib in adults with moderate-to-severe atopic dermatitis across eight centers in central Italy.

Materials and methods: A total of 150 patients received upadacitinib 15 mg or 30 mg daily as monotherapy. Clinical outcomes were evaluated up to 104 weeks using Eczema Area and Severity Index (EASI), itch and sleep numeric rating scale (NRS), and Dermatology Life Quality Index (DLQI).

Results: Both dosages led to significant and sustained improvements in disease severity, pruritus, sleep disturbances, and quality of life, with 77.8% achieving EASI 75 and 39.2% achieving EASI 100 at week 16. Responses were similar between doses, although long-term itch control was better in the 30 mg group. Higher baseline EASI score was a positive predictor of response, while head and neck involvement and prior systemic treatments, particularly cyclosporine, were associated with poorer outcomes. The safety profile was consistent with prior reports, with acneiform eruption, elevated creatine phosphokinase (CPK), and dyslipidemia being the most common adverse events. No reactivation of atopic keratoconjunctivitis was observed.

Conclusions: These findings support the efficacy, safety, and flexibility of upadacitinib dosing in clinical practice.

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