Early itch relief with upadacitinib predicts later skin clearance in Atopic dermatitis

Abstract

Background

Though Janus kinase inhibitors such as upadacitinib rapidly relieve itch in atopic dermatitis (AD) patients, how early itch relief impacts later skin clearance is not examined.

Objectives

This study aims to determine if early itch relief by upadacitinib could predict complete skin clearance in later phases.

Methods

This retrospective study involved 105 patients with moderate-to-severe AD treated with upadacitinib 15 mg/day. Eczema area and severity index (EASI), atopic dermatitis control tool, and achievement rate of EASI 100 were evaluated at weeks 4, 12, and 24. The threshold of early peak pruritus-numerical rating scale (PP-NRS) predicting later skin clearance was assessed by area under the receiver-operating characteristic curve, and predictors for EASI 100 achievement were determined by logistic regression analysis.

Results

The rate of achieving EASI 100 at week 24 was extremely higher in patients who achieved week 2 PP-NRS ≤ 1 (42.9%) than in non-achievers (1.4%). The logistic regression analysis showed that the achievement of week 2 PP-NRS ≤ 1 and low body mass index were associated with achievement of EASI 100 at weeks 12 and 24.

Conclusions

The achievement of week 2 PP-NRS ≤ 1 may predict later skin clearance in upadacitinib treatment.

Keywords:

• Atopic dermatitis
• upadacitinib
• Janus kinase inhibitor
• itch
• skin clearance

Author contributions

Teppei Hagino conceptualized the study, and mainly organized the manuscript. Mai Yoshida and Risa Hamada performed the statistical analyses. Naoko Kanda supervised the study. Hidehisa Saeki and Eita Fujimoto revised the manuscript.

Disclosure statement

Hidehisa Saeki received a lecture fee and research cost from AbbVie GK. Teppei Hagino and Naoko Kanda received lecture fees from AbbVie GK.

Data availability statement

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Additional information

Funding

This research was partially supported by the grant, Initiative for Realizing Diversity in the Research Environment from MEXT, Japan.