644 - Effectiveness and safety of upadacitinib in adolescent and adult patients with atopic dermatitis: an interim analysis of week 20-32 data from a real-world multicenter retrospective review
Notice bibliographique
Résumé
Abstract Introduction While clinical trial data demonstrates the efficacy and safety of upadacitinib (UPA), a selective oral Janus kinase inhibitor (JAKi) for atopic dermatitis (AD), there is still a lack of real-world evidence. Objectives Our study evaluated the real-world effectiveness and safety of UPA for AD at weeks 20-32. Methods We conducted a multicenter retrospective review at three practices in Canada. Effectiveness endpoints evaluated at weeks 20-32 included Investigator Global Assessment (IGA) score of clear or almost clear (IGA 0/1) as well as improvements in Eczema Area and Severity Index (EASI), body surface area (BSA), IGAxBSA, and Dermatology Life Quality Index (DLQI)/Children’s DLQI (CDLQI). Safety was determined via incidence of treatment-related adverse events (AEs). Results A total of 131 patients were included in the analysis. Mean age was 44.3 ± 17.5 (range: 12-78) years; 53.4% (70/131) were female. UPA doses were 15 mg (43.5%, 57/131) or 30 mg (56.5%, 74/131) once daily. Previous treatments included: topical therapy (100%, 131/131), phototherapy (29%, 38/131), systemic non-biologic therapy (75.6%, 99/131), and systemic biologic/JAKi therapy (38.9%, 51/131). At weeks 20-32: 85.5% (112/131) of patients achieved IGA 0/1; 84.3% (59/70), 75.7% (53/70), and 62.9% (44/70) of patients achieved EASI improvements of 75% (EASI75), 90% (EASI90), and 100% (EASI100), respectively; mean EASI was reduced from 12.7 to 0.7 (p=0.0001; mean EASI improvement = 88.8%); 94.3% (66/70), 92.9% (65/70), 90% (63/70), and 77.1% (54/70) of patients achieved absolute EASI scores <7, 5, <3, and <1, respectively; mean BSA was reduced from 16.4% to 0.9% (p=0.0001; mean BSA improvement=92.5%); mean IGAxBSA was reduced from 53.5 to 1.6 (p=0.0001; mean IGAxBSA improvement=95.7%); and mean DLQI/CDLQI was reduced from 13 to 1.2 (p=0.0001; mean DLQI/CDLQI improvement=90.5%), with 84.6% (55/65) of patients achieving DLQI/CDLQI 0/1. UPA monotherapy was utilized in 38.9% (51/131) of cases. Common concomitant therapies included topical corticosteroids (56.5%, 74/131), systemic corticosteroids (5.3%, 7/131), and topical calcineurin inhibitors (3.8%, 5/131). Frequent AEs included: acne (18.3%, 24/131), hypertriglyceridemia (18.3%, 24/131), elevated creatine phosphokinase (12.2%, 16/131), herpes simplex (5.3%, 7/131), and transaminitis (5.3%, 7/131). Five patients (3.8%) discontinued UPA due to treatment-related AEs (myalgia/arthralgia [n=2]; gastrointestinal discomfort [n=1]; venous thromboembolism [n=1]; folliculitis [n=1]). No serious infections, tuberculosis, major adverse cardiovascular events, gastrointestinal perforation, or malignancy were observed in 67.4 patient-years of safety follow-up. Conclusions Our real-world study shows that UPA is an effective and safe therapy for AD, with high levels of skin clearance and a favorable safety profile between weeks 20-32. These results indicate that UPA may perform better in the real-world versus clinical trial setting, as compared to the Heads Up and Rising Up studies at week 24, specifically for IGA 0/1 and EASI75/EASI90/EASI100 achievement. This may be explained by less severe baseline disease severity in our study. Limitations of this study include its sample size and retrospective nature.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,015 | 0,020 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,004 |
| Bibliométrie | 0,002 | 0,003 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,000 |
| Intégrité de la recherche | 0,001 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,001 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».