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Publications

Journal Article Ahead of print

PubMed: 42823606 DOI: 10.1007/s13555-026-01940-6

Long-Term Disease Control During Continuous Treatment with Upadacitinib and Baricitinib for Moderate-to-Severe Atopic Dermatitis: a Real-World Monocentric Retrospective Study.

Dermatol Ther (Heidelb)

Authors: Francesco D'Oria, Costanza Falcidia, Giulio Foggi, Matteo Bianco, Ruggero Cascio Ingurgio, Angela Alfano, Luciano Ibba, Mario Valenti, Antonio Costanzo, Alessandra Narcisi, Luigi Gargiulo

Affiliations

  • Department of Biomedical Sciences, Humanitas University, 20072, Pieve Emanuele, MI, Italy.
  • Dermatology Unit, IRCCS Humanitas Research Hospital, 20089, Rozzano, Italy.
  • Department of Biomedical Sciences, Humanitas University, 20072, Pieve Emanuele, MI, Italy.
  • Dermatology Unit, IRCCS Humanitas Research Hospital, 20089, Rozzano, Italy.

Abstract

INTRODUCTION

Real-world evidence on long-term effectiveness and safety of oral Janus kinase (JAK) inhibitors in atopic dermatitis (AD) remains limited. This study evaluated sustained long-term clinical and patient-reported disease control and safety during continuous treatment with upadacitinib 30 mg or baricitinib 4 mg.

METHODS

This monocentric retrospective study included adults with moderate-to-severe AD treated at IRCCS Humanitas Research Hospital. Eligible patients had baseline assessments and completed longitudinal follow-ups while remaining on their assigned JAK inhibitor. Outcomes were assessed through week 260 for upadacitinib and week 312 for baricitinib and included Eczema Area and Severity Index (EASI) 75/90/100, EASI ≤ 7/≤ 3, Investigator Global Assessment (IGA) 0/1, mean EASI, Peak Pruritus Numerical Rating Scale (PP-NRS), Sleep Disturbance Numerical Rating Scale (SD-NRS) improvement and remission endpoints, and safety. Between-treatment comparisons were considered exploratory only.

RESULTS

The long-term cohort included 41 patients: 34 received upadacitinib and 7 baricitinib. At week 260, EASI 75, EASI 90, EASI ≤ 7, and EASI ≤ 3 were achieved by 97.1%, 91.2%, 100.0%, and 91.2% of upadacitinib-treated patients, respectively. In the baricitinib group, EASI 75 was maintained by all patients from week 32 to week 312, and EASI 90, EASI ≤ 7, and EASI ≤ 3 were achieved by all patients at week 312. IGA 0/1 and mean EASI indicated sustained low disease activity during follow-up. At week 260, ΔPP-NRS ≥ 4 and ΔSD-NRS ≥ 4 were maintained in 82.4% and 73.5% of upadacitinib-treated patients and in 85.7% and 71.4% of baricitinib-treated patients, with corresponding baricitinib rates maintained at week 312. Adverse events were infrequent, with no serious adverse events, treatment interruptions, or permanent discontinuations in the long-term cohort.

CONCLUSIONS

In selected patients remaining on continuous treatment, upadacitinib and baricitinib were associated with sustained long-term clinical and patient-reported control of moderate-to-severe AD. Larger prospective studies are needed to clarify outcomes after dose reduction or discontinuation and the potential for deeper disease remodeling.

MeSH

Safety, Dermatitis, Retrospective Studies, Therapeutics, Janus Kinase Inhibitors, Dermatitis, Atopic