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 monother...

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Main Authors: 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
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Journal of Dermatological Treatment
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Online Access:https://www.tandfonline.com/doi/10.1080/09546634.2025.2509541
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author 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
author_facet 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
author_sort Edoardo Mortato
collection DOAJ
description 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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spelling doaj-art-730b3a179da245b58735ec0deece2a0d2025-08-20T03:25:16ZengTaylor & Francis GroupJournal of Dermatological Treatment0954-66341471-17532025-12-0136110.1080/09546634.2025.2509541Use of upadacitinib in the treatment of moderate to severe atopic dermatitis: patient profiling, dose selection, and therapy modulation, what does real-life teach us?Edoardo Mortato0Niccolò Gori1Giacomo Caldarola2Marina Talamonti3Claudia Paganini4Luisa Boeti5Filomena Russo6Teresa Grieco7Ersilia Tolino8Gaia Moretta9Flavia Pigliacelli10Rosa Coppola11Domenico Giordano12Camilla Chello13Concetta Potenza14Maria Concetta Fargnoli15Vincenzo Panasiti16Barbara Cocuroccia17Ketty Peris18Marco Galluzzo19Department of Systems Medicine, University of Rome "Tor Vergata", Rome, ItalyDepartment of Translational Medicine and Surgery, Section of Dermatology, Catholic University of the Sacred Heart, Rome, ItalyDepartment of Translational Medicine and Surgery, Section of Dermatology, Catholic University of the Sacred Heart, Rome, ItalyDermatology Unit, Fondazione Policlinico "Tor Vergata", Rome, ItalyDepartment of Systems Medicine, University of Rome "Tor Vergata", Rome, ItalyDepartment of Translational Medicine and Surgery, Section of Dermatology, Catholic University of the Sacred Heart, Rome, ItalyDepartment of Dermatology, Istituto Dermopatico dell’Immacolata IRCCS Roma, Rome, ItalyDepartment of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Dermatology Clinic, Sapienza University of Rome, Rome, ItalyDepartment of Medical and Surgical Sciences and Biotechnologies, Dermatology Unit "D. Innocenzi", Sapienza University of Rome-Polo Pontino, Latina, ItalyDepartment of Dermatology, Istituto Dermopatico dell’Immacolata IRCCS Roma, Rome, ItalySan Gallicano Dermatological Institute, IRCCS, Rome, ItalyOperative Research Unit of Dermatology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, ItalyDepartment of Neurosciences, Mental Health and Sensory Organs, Sapienza University, Rome, ItalyDepartment of Clinical Internal, Anesthesiological and Cardiovascular Sciences, Dermatology Clinic, Sapienza University of Rome, Rome, ItalyDepartment of Medical and Surgical Sciences and Biotechnologies, Dermatology Unit "D. Innocenzi", Sapienza University of Rome-Polo Pontino, Latina, ItalySan Gallicano Dermatological Institute, IRCCS, Rome, ItalyOperative Research Unit of Dermatology, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, ItalyDepartment of Dermatology, Istituto Dermopatico dell’Immacolata IRCCS Roma, Rome, ItalyDepartment of Translational Medicine and Surgery, Section of Dermatology, Catholic University of the Sacred Heart, Rome, ItalyDepartment of Systems Medicine, University of Rome "Tor Vergata", Rome, ItalyPurpose 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.https://www.tandfonline.com/doi/10.1080/09546634.2025.2509541Upadacitinibatopic dermatitishead and neck dermatitisJAK inhibitors
spellingShingle 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
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?
Journal of Dermatological Treatment
Upadacitinib
atopic dermatitis
head and neck dermatitis
JAK inhibitors
title 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?
title_full 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?
title_fullStr 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?
title_full_unstemmed 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?
title_short 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?
title_sort 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
topic Upadacitinib
atopic dermatitis
head and neck dermatitis
JAK inhibitors
url https://www.tandfonline.com/doi/10.1080/09546634.2025.2509541
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