Upadacitinib is an efficacious treatment for individuals with moderate-to-severe atopic dermatitis, including those with prior poor response to Dupilumab and/or Baricitinib.

This study examined the efficacy of sixteen weeks of Upadacitinib (a selective Janus kinase-1 inhibitor) for atopic dermatitis management in adults.

In this multicentre prospective study, 47 patients from the Dutch BioDay registry managed with Upadacitinib were enrolled. Volunteers were evaluated at baseline, and following four, eight and sixteen weeks of treatment. Using clinician- and patient-reported outcome measurements, efficacy was investigated. With the aid of adverse events and laboratory assessments, safety was examined.

The odds (95% confidence intervals) of attaining an Eczema Area and Severity Index (EASI) of <7 and Numerical Rating Scale (NRS) - pruritus score of ≤4 were found to be 73.0% (53.7-86.3) and 69.4% (48.7-84.4) respectively. In patients who did not respond well to Dupilumab and/or Baricitinib, as well as in patients who were unaware of these therapies or who had discontinued them due to side effects, Upadacitinib's effectiveness was comparable.

Notably, 14 patients (29.8%) stopped using Upadacitinib because it was not effective (8.5%), had negative side effects (14.9%), or both (6.4%). Herpes simplex (n = 6, 12.8%), Acneiform eruptions (n = 10, 21.3%), nausea (n=4, 8.5%), and airway infections (n = 4, 8.5%) were the most frequently reported side effects.

In atopic dermatitis-affected adults, including those with prior unsatisfactory response to Dupilumab and/or Baricitinib treatment, Upadacitinib is a promising therapeutic option.