Management of Patients Affected by Moderate-to-Severe Atopic Dermatitis with JAK Inhibitors in Real-World Clinical Practice: An Italian Delphi Consensus

Dermatology and Therapy, Год журнала: 2024, Номер 14(4), С. 919 - 932

Опубликована: Март 21, 2024

Several systemic therapies have been approved for the treatment of severe AD. In particular, Janus kinase inhibitors (JAKi), including abrocitinib, baricitinib, and upadacitinib, recently received approval patients with AD after being evaluated in several clinical trials. However, a few concerns raised regarding their long-term safety management these drugs real-world practice. this article we described results Delphi consensus aimed at describing knowledge on JAKi focusing, providing recommendations dermatologists daily practice use drugs. Twelve Italian reviewed most recent literature efficacy profiles proposed 24 statements. Agreement was reached statements focusing three main topics: (1) place therapy moderate-to-severe AD; (2) effectiveness JAK different phenotypes; (3) approaches to treated The panel all Given wide practice, it is crucial establish specific follow-up each patient's phenotype order achieve best possible outcome minimize potential adverse events.

Язык: Английский

---

Real‐World Efficacy and Safety of Abrocitinib in Chinese Atopic Dermatitis Patients: A Single‐Center Prospective Study

Allergy, Год журнала: 2025, Номер unknown

Опубликована: Фев. 10, 2025

Phase 3 trials have demonstrated the efficacy and safety of abrocitinib for atopic dermatitis (AD), but real-world evidence remains limited. This study prospectively enrolled 117 moderate-to-severe AD patients at Huashan Hospital, Shanghai, China. Physician- patient-reported outcomes were evaluated multiple time points. Blood eosinophil counts, serum IgE, 24 cytokines/chemokines measured. Abrocitinib treatment led to rapid potent improvements in disease severity. At week 12, 74.3% 50.5% achieved least 75% 90% improvement eczema area severity index (EASI), respectively. Compared dupilumab, showed greater Itch-NRS 2 a higher proportion EASI-75 4. Adverse events occurred 42.7% patients, with gastrointestinal symptoms being most common (17.1%). No tuberculosis (TB) reactivation was observed who screened positive TB received isoniazid prophylaxis during period. Lower body mass (BMI < 24; adjusted OR: 4.01, 95% CI: 1.36-11.73) no prior dupilumab use (adjusted 5.81, 1.8-18.7) identified as predictors good response. By 4, blood counts IgE significantly decreased. Reductions Th2-, Th1-, Treg-related after 4 weeks treatment, including IL-5, CCL17, CCL18, TNF-α, IL-6, IL-10, CD25/IL-2Rα, more pronounced responders. robust well-tolerated profile Chinese routine clinical practice, accompanied by normalization elevated biomarkers. ChiCRT Identifier: ChiCTR2200063195.

Язык: Английский

---

Real-world Experience of Abrocitinib Treatment in Patients with Atopic Dermatitis and Hand Eczema: Up to 28-week Results from the BioDay Registry

Acta Dermato Venereologica, Год журнала: 2024, Номер 104, С. adv19454 - adv19454

Опубликована: Фев. 7, 2024

Limited daily practice data on the effect of abrocitinib in patients with atopic dermatitis are available. The aim this multicentre prospective study is to evaluate effectiveness and safety treated practice. In a subgroup, hand eczema was evaluated. A total 103 from BioDay registry were included study: week 4 (n = 95), 16 61) 28 39). At 28, Eczema Area Severity Index (EASI)-50/75/90 achieved by 81.8%, 57.6%, 18.2%, respectively, weekly average pruritus numerical rating scale ≤ 62.9%. not significantly different between dupilumab non-responders dupilumab-naïve patients/responders, upadacitinib upadacitinib-naïve patients/responders. Mean ± standard deviation Hand decreased 27.4 27.7 at baseline 7.7 12.1 31). Thirty-two (31.1%) discontinued treatment due ineffectiveness 17), adverse events 9) or both 3). most frequently reported event nausea 28). conclusion, an effective for can be previous inadequate response upadacitinib. Furthermore, improve dermatitis.

Язык: Английский

---

Practical Use of Upadacitinib in Patients with Severe Atopic Dermatitis in a Real-World Setting: A Systematic Review

Clinical Cosmetic and Investigational Dermatology, Год журнала: 2024, Номер Volume 17, С. 593 - 604

Опубликована: Март 1, 2024

Upadacitinib is a selective Janus kinase inhibitor approved for the treatment of severe atopic dermatitis (AD). This systematic review aims to summarize most recent data in terms effectiveness and safety upadacitinib AD real-world setting. The included comprehensive search databases, including PubMed, Google Scholar Web Science, according Preferred Reporting Items Systematic Reviews Meta-analysis (PRISMA) guidelines. literature initially identified 242 studies. Of these, 214 were excluded after reviewing their titles abstracts. We then conducted full-text 25 studies, which 17 met our inclusion criteria therefore review. analysis studies showed high upadacitinib, both clinical signs subjective symptoms, different patient populations, those resistant other treatments. No new significant concerns have emerged as compared randomized trials.

Язык: Английский

---

Biologics Versus JAK Inhibitors. Part II: Risk of Infections. A Narrative Review

Dermatology and Therapy, Год журнала: 2024, Номер 14(8), С. 1983 - 2038

Опубликована: Июль 16, 2024

The risk of infections associated with biological drugs (BD) and Janus kinase inhibitors (JAKi) has been extensively explored in the literature. However, there is a dearth studies that evaluate both pharmacological groups together and, furthermore, compare them. Here, we review BD JAKi used dermatology.

Язык: Английский

---

Treatment of atopic dermatitis with abrocitinib in real practice in Spain: efficacy and safety results from a 24‐week multicenter study

International Journal of Dermatology, Год журнала: 2024, Номер 63(11)

Опубликована: Июнь 21, 2024

Abstract Background Abrocitinib, a selective JAK 1 inhibitor, was recently approved in Europe. Despite its approval, real‐world data on efficacy and safety treating moderate‐to‐severe atopic dermatitis (AD) remains limited. Objectives This study aimed to evaluate the short‐term effectiveness of abrocitinib real‐life setting for patients with AD. Methods We conducted retrospective multicenter involving adult AD who started treatment between May 1, 2023, September 30, 15 Spanish hospitals. Treatment doses were 100 or 200 mg daily, based clinical assessment. Data collection included patient demographics, history, comorbidities, previous treatments, disease severity indicators such as SCORing (SCORAD), Eczema Area Severity Index (EASI), body surface area, Peak Pruritus NRS scores at baseline, 4, 12, 24 weeks. Quality life measured using Dermatology Life (DLQI), assessed by monitoring adverse reactions various biochemical parameters. Results The cohort comprised 76 an average age 33.93 years; 57.89% male. Before abrocitinib, 36.84% naïve advanced therapies. baseline mean SCORAD 47.04, EASI 21.79, DLQI 15.01. At Week 24, there significant improvements: reduced 2.81, 70.58% achieved 75. However, 18.42% discontinued mainly due inefficacy effects. profile favorable, 22.37% reporting mild events (AEs) one serious case cutaneous lymphoma. Conclusions first series assessing conditions reveals improvement symptoms quality range prior failures. Abrocitinib well‐tolerated, few AEs, highlighting potential effective option

Язык: Английский

---

Exploring the immunological underpinnings of allergic conjunctivitis: the role of CD4 + T Cells and SLAM expression in ocular surface disease

International Ophthalmology, Год журнала: 2025, Номер 45(1)

Опубликована: Фев. 18, 2025

Язык: Английский

---

Long-term Outcomes of New Systemic Agents in Atopic Dermatitis: Drug Survival Analyses and Treatment Patterns in Daily Practice

Acta Dermato Venereologica, Год журнала: 2025, Номер 105, С. adv41504 - adv41504

Опубликована: Март 9, 2025

In recent years, several new systemic agents (biologics and Janus kinase inhibitors [JAKi]) have been registered for the treatment of moderate-to-severe atopic dermatitis (AD). However, comparisons real-world drug survival data insights into patterns these advanced systemics are limited. Data from a prospective observational single-centre registry were collected 549 adult AD patients (759 courses) receiving biologics (dupilumab, tralokinumab) or JAKi (abrocitinib, baricitinib, upadacitinib) analysed using Kaplan–Meier curves. Cox regression analyses used to evaluate predictors survival. Frequencies percentages summarized on initial subsequent treatments received, with Sankey diagram illustrating switching patterns. The 18-month overall rates dupilumab, abrocitinib, upadacitinib, tralokinumab, baricitinib 70.0%, 51.5%, 48.4%, 39.4%, 20.4%, respectively. No significant identified. Dupilumab was predominant (87.2%) upadacitinib most frequently second third treatment. total cohort, 57.9% remained their 26.8% switched other treatments. conclusion, dupilumab showed superior while had lowest rate. Frequent highlights need biomarkers that predict response improve attrition rates.

Язык: Английский

---

Abrocitinib Treatment Modes: Impact on Prognosis and Relapse Rates in Atopic Dermatitis

Dermatitis, Год журнала: 2025, Номер unknown

Опубликована: Апрель 2, 2025

Background: Although clinical studies have demonstrated the effectiveness and safety of abrocitinib for moderate to severe atopic dermatitis (AD), real-world evidences are limited. In particular, exploring impact different treatment modes on prognosis currently lacking. Objective: This study aimed investigate effects various regimens AD. Methods: A retrospective was conducted at Southwest Hospital Army Military Medical University involved patients with AD receiving abrocitinib. After disease control, were given option continue, taper, or discontinue based their preferences. Clinical data from eligible retrospectively collected between August 2023 April 2024. Results: maintenance group (100 mg/day), EASI-75, pp-NRS4 achieved by 33.3% 58.3% patients, respectively, a mean reduction 12.8 points in Dermatology Quality Life Index (DLQI) compared baseline. Patients who completed 12-week induction period (including both tapering groups) showed greater improvement SCORing (P < 0.0001; P = 0.0002), Eczema Area Severity Peak Pruritus Numerical Rating Scale (all 0.0001), DLQI as well longer time relapse, those discontinuation group. Conclusion: Continuous completion associated improved outcomes reduced relapse rates patients.

Язык: Английский

---

Successful treatment of severe diffuse alopecia areata with abrocitinib

Anais Brasileiros de Dermatologia, Год журнала: 2025, Номер unknown

Опубликована: Апрель 1, 2025

Язык: Английский

---