Real-World Efficacy and Safety of Upadacitinib in Korean Patients With Atopic Dermatitis

Abstract

Purpose: Upadacitinib is an oral selective Janus kinase (JAK)1 inhibitor that has demonstrated high efficacy in clinical trials for patients with atopic dermatitis (AD). However, clinical trial settings may not always reflect real-world practice. This study aimed to assess the real-world efficacy and safety of upadacitinib in AD patients. Methods: One hundred fifteen AD patients treated with upadacitinib were retrospectively analyzed using medical records. Patients who received treatment for at least 16 weeks were included. In the moderate-to-severe AD group, efficacy was assessed by the proportion of patients achieving Eczema Area and Severity Index (EASI) 50, EASI 75, and EASI 90 at weeks 2 and 16 compared to baseline, whereas efficacy in the mild AD group was evaluated based on the reduction in patient-reported outcomes. Results: The mean EASI score significantly decreased after 16 weeks of upadacitinib treatment. At week 2, 67%, 35%, and 6% of moderate-to-severe AD patients achieved EASI 50, EASI 75 and EASI 90, respectively. At week 16, 88%, 71%, and 31% of moderate-to-severe AD patients achieved EASI 50, EASI 75 and EASI 90, respectively. Patient-reported outcome measures improved rapidly within 2 weeks and were sustained through week 16. The most common adverse event was acne, occurring in 35 patients (41.2%) with mild severity. No serious adverse events occurred. Conclusions: Upadacitinib is effective and safe for AD patients in a real-world clinical setting.