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与Upadacitinib使用相关的双水性湿疹:一个矛盾的不良事件或偶然性?
Gisela Piñero1, María Puig1, Míriam Mañosa Círia2
1Gastroenterology, Hospital Universitari Germans Trias i Pujol .
Revista espanola de enfermedades digestivas
|February 25, 2026
概括
本案例研究详细介绍了一名克罗恩氏病患者,在开始服用upadacitinib (UPA) 后,他患上了脱水性湿疹. 皮肤状况通过治疗得到解决,而克罗恩氏病仍然处于缓解状态,突出显示了这种JAK抑制剂的潜在副作用.
科学领域:
- 胃肠病学 胃肠病学
- 皮肤病学 皮肤病学
- 免疫学 免疫学 免疫学
背景情况:
- 克罗恩病 (CD) 管理通常涉及耐火病例的先进疗法.
- 对生物药物如因弗利西马布和乌斯特基努马布的反应丧失需要探索替代治疗方法.
- 选择性JAK1抑制剂Upadacitinib (UPA) 为炎症性疾病提供了一种新的治疗途径.
研究的目的:
- 报告一个克罗恩氏病患者 de novo dyshidrotic 湿疹的病例,该病患者接受了upadacitinib治疗.
- 讨论这种不良事件背后的潜在免疫机制.
- 为了突出upadacitinib在治疗严重CD的安全性和有效性,尽管发生了矛盾的皮肤反应.
主要方法:
- 一名39岁的男性患有耐火性结肠直肠性克罗恩病,他开始接受上巴西提尼布 (45毫克/天).
- 进行了临床,生化和内镜评估,以监测CD活性.
- 皮肤学评估诊断并管理了新出现的皮肤状况.
主要成果:
- 患者实现了克罗恩病的快速临床,生化和内镜缓解.
- 在开始服用upadacitinib后的两周内,该患者出现了de novo dyshidrotic湿疹.
- 湿疹通过局部皮质类固醇而没有中断上达西替尼治疗而消失;在9个月后,CD仍然处于缓解状态.
结论:
- 在克罗恩氏病患者中,upadacitinib可以诱导二水性湿疹,这是这个特定情况下以前未报告的不良事件.
- 选择性JAK1抑制可能导致免疫失调,可能导致矛盾的皮肤反应.
- 乌帕达西替尼在治疗严重克罗恩病方面表现出有效性,即使这种皮肤病副作用的同时发展和成功管理.
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