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Safety and Effectiveness of Upadacitinib in Patients with Moderate-to-Severe Atopic Dermatitis Who Smoke: a 2-Year
Francesco Leo1, Michela Ortoncelli2, Ruggero Cascio Ingurgio3
1Dermatology Section, Department of Medical Sciences, Dermatology Clinic, University of Turin, Via Cherasco 23, 10121, Torino, Italy. f.leo@unito.it.
Background:
Atopic dermatitis (AD) is a chronic inflammatory skin condition that significantly impairs the quality of life. Recent advancements in systemic therapies, such as Janus kinase (JAK) inhibitors, offer very effective new treatment options. However, concerns regarding potential adverse events, including cardiovascular and thromboembolic risk, have emerged from clinical studies and call for further real-life investigations. This has highlighted the need to establish specific risk categories, such as tobacco smokers.
Objective:
This study aims to evaluate the safety and effectiveness of upadacitinib, a JAK1 inhibitor, in patients who smoke with moderate-to-severe AD over a 2-year treatment period, comparing outcomes with patients who do not smoke.
Patients And Methods:
A retrospective multicenter study was conducted across 12 dermatology departments in Italy, including 375 patients treated with upadacitinib. The presence and intensity of smoking habits as well as effectiveness scores and safety data were collected.
Results:
Patients who smoke accounted for 36.8% of the sample. Two thromboembolic events in patients who do not smoke were recorded in the 2-year (median follow up of 52.6 weeks) observation period. The most common adverse event was acneiform eruption (12.4% of patients after 104 weeks). No significant differences related to safety emerged regarding the presence or absence of a smoking habit. Drug survival was very high with no differences between the two cohorts (83.5% after 104 weeks for patients who smoke).
Conclusions:
This study suggests that upadacitinib is a safe and effective treatment for moderate-to-severe AD in presence of tobacco smoke, with no significant differences in safety or effectiveness compared with patients who do not smoke.
Insights
Upadacitinib is a safe and effective treatment for atopic dermatitis (AD) in smokers, showing no significant safety or efficacy differences compared to non-smokers over two years.
Area of Science:
- Dermatology
- Pharmacology
- Clinical Research
Background:
- Atopic dermatitis (AD) is a chronic inflammatory skin condition impacting quality of life.
- Janus kinase (JAK) inhibitors offer effective treatment for AD.
- Concerns about cardiovascular and thromboembolic risks necessitate real-world safety data, especially for smokers.
Purpose of the Study:
- To assess the safety and effectiveness of upadacitinib (a JAK1 inhibitor) in patients with moderate-to-severe AD who smoke.
- To compare outcomes between patients who smoke and those who do not smoke over a 2-year period.
Main Methods:
- Retrospective multicenter study involving 375 patients treated with upadacitinib across 12 Italian dermatology departments.
- Data collected included smoking habits, effectiveness scores, and safety information.
- Comparison of outcomes between smokers and non-smokers.
Main Results:
- Smokers constituted 36.8% of the study population.
- No significant safety differences were observed between smokers and non-smokers.
- Drug survival was high (83.5% at 104 weeks) and similar in both cohorts.
- The most frequent adverse event was acneiform eruption (12.4% at 104 weeks).
Conclusions:
- Upadacitinib demonstrates a favorable safety and efficacy profile for moderate-to-severe AD in patients who smoke.
- Smoking status does not appear to significantly alter the safety or effectiveness of upadacitinib treatment.
- Real-world data support the use of upadacitinib in AD patients, including smokers.
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