Upadacitinib Linked with Improvement for Hand Eczema in Patients with Atopic Dermatitis

The new observational analysis looked at a variety of outcome measures.

Results from a new study suggest that upadacitinib is efficacious for the treatment of hand eczema (HE) and atopic dermatitis (AD) in patients with AD. 

The study authors, publishing in Contact Dermatitis, included a total of 38 patients in the observational cohort analysis (32 of whom had HE) from the Dutch BioDay registry patients from the dermatology departments of the University Medical Center Groningen and the Medical Center Leeuwarden. They looked at outcomes in upadacitinib-treated patients using data from the Eczema Area and Severity Index (EASI), Investigator's Global Assessment (IGA), Hand Eczema Severity Index (HECSI), Photographic guide and PROMs, average pruritus and pain Numeric Rating Scale (NRS) score of the past week, Patient-Oriented Eczema Measure (POEM), Patient-Oriented Eczema, Dermatology Life Quality Index (DLQI), Atopic Dermatitis Control Tool (ADCT), Patient Global Assessment of Disease (PGAD), Quality Of Life Hand Eczema Questionnaire (QOLHEQ) at baseline, Week 4, and Week 16. Six patients dropped out the study and ceased taking upadacitinib. 

At week 16, EASI-75 was achieved by half of the patients (50.0%). The safety analysis showed no difference from the clinical trials. A total of 62.5% of patients achieved absolute cutoff score NRS-pruritus ≤4, 37.5% achieved POEM ≤7, 59.4% achieved DLQI ≤5, 68.8% achieved ADCT <7, and 53.1% achieved a PGAD rating of at least ‘good.' HECSI-75 was achieved by 59.3%, and 74.1% achieved (almost) clear on the Photographic guide. The minimally important change in QOLHEQ was achieved by 57.9% of patients. 

Small sample size and the inability to perform sub-analyses on dosages were cited as limitations on the generalizability of the results. 

"Upadacitinib can be an effective treatment for patients with AD," the authors wrote in the study. "In addition, this study showed a marked improvement of HE in patients treated with upadacitinib for AD. Future studies should focus on the effect of upadacitinib on chronic HE, especially on the different etiological subtypes of HE, including HE in non-atopic individuals."

Source

Kamphuis EI, Loman L, Han H, et al. Experiences from daily practice of upadacitinib treatment on atopic dermatitis with a focus on hand eczema: Results from the BioDay registry. Contact Dermatitis. 2023;88(5):351-362.

Disclosures

The BioDay registry is sponsored by Sanofi/Regeneron, AbbVie, Pfizer, Leo Pharma and Eli Lilly. They had no influence on the collection, analysis and interpretation of the data. Klaziena Politiek received consultancy fees for AbbVie, LEO Pharma and Sanofi Genzyme. Marie Schuttelaar is a consultant, advisory board member and/or speaker for AbbVie, Pfizer, Leo Pharma, Sanofi Genzyme, Eli Lilly and Galderma. All other authors report no relevant financial conflicts.