TOPLINE:
Upadacitinib, a Janus kinase 1 inhibitor, demonstrated comparable safety and effectiveness over 2 years in patients with moderate to severe atopic dermatitis (AD), regardless of smoking status.
METHODOLOGY:
- This retrospective multicentre study included 375 patients with moderate to severe AD who were treated with upadacitinib for up to 2 years.
- Researchers assessed the safety and effectiveness of upadacitinib in patients with AD who smoked (n = 138) and compared their outcomes with those of patients with AD who did not smoke (n = 237).
- The effectiveness of upadacitinib was analysed using the Eczema Area and Severity Index (EASI), Pruritus-Numerical Rating Scale (P-NRS), Sleep Loss–Numerical Rating Scale (S-NRS), and Dermatology Life Quality Index (DLQI).
- Adverse events during the treatment and drug survival after 104 weeks were also evaluated.
TAKEAWAY:
- At 2 years, a 100% improvement from baseline in EASI was notably higher in patients who smoked than in those who did not smoke (68.6% vs 44.4%; P = .016).
- Mean DLQI scores were better for patients who smoked than for those who did not smoke at both 28 weeks (2.17 vs 3.81; P = .004) and 104 weeks (0.77 vs 1.85; P = .043).
- P-NRS and S-NRS scores were statistically significantly different between the groups only at the initial timepoint, with patients who smoked having lower mean P-NRS (P = .046) and S-NRS (P = .017) scores than those who did not.
- The drug survival rate after 104 weeks reached 80.8% in the total population, with no significant differences between patients who smoked and those who did not smoke (83.5% vs 79.8%; P = .236).
- Acneiform eruption emerged as the most common adverse event, affecting 12.4% of patients after 104 weeks, with no significant differences with respect to smoking status.
IN PRACTICE:
"The results of our real-world study seem to demonstrate the effectiveness and safety profile of upadacitinib in patients who smoke treated with upadacitinib for moderate to severe AD, showing no significant differences related to tobacco smoking," the authors wrote.
SOURCE:
The study was led by Francesco Leo, MD, Department of Medical Sciences, Dermatology Clinic, University of Turin, Turin, Italy. It was published online on February 24, 2025, in the American Journal of Clinical Dermatology.
LIMITATIONS:
The study findings were limited by the retrospective nature and the absence of a control group. Additionally, the 2-year duration may not have been sufficient to fully assess long-term safety implications.
DISCLOSURES:
The study did not receive any external funding. Several authors reported having ties with various sources.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
