Comparative effectiveness of upadacitinib versus dupilumab for moderate-to-severe atopic dermatitis: A retrospective cohort study

IF 4.8 2区 医学 Q2 IMMUNOLOGY International immunopharmacology Pub Date : 2024-10-14 DOI:10.1016/j.intimp.2024.113383
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Abstract

Background

Although efficacy and safety of Upadacitinib and Dupilumab in moderate to severe atopic dermatitis (AD) have been shown in clinical trials, real world data are still limited. The aim of this retrospective study is to indirectly compare the efficacy and safety of Upadacitinib and Dupilumab in patients with moderate to severe AD in real world practice.

Methods

A single-center retrospective cohort study was conducted. The study included patients with moderate to severe AD, who were enrolled from May 2022 to March 2024, to indirectly compare the efficacy and safety of Upadacitinib and Dupilumab over 12 weeks duration.

Results

Eighty-seven patients were included (46 received Upadacitinib and 41 Dupilumab). Compared with week 0, there was a significant decrease in EASI score, ADCT score and NRS score in patients of both groups in weeks 4, 8, and 12. In week 4, the reduction in EASI score, ADCT score and NRS score was significantly greater in patients of Upadacitinib group compared to those in Dupilumab group. Compared to baseline, in week 12, the decrease in IL-4, IL-13, and IL-31 level in the serum of patients in Upadacitinib group was significantly greater than that of patients in Dupilumab group. The total IgE of patients in Dupilumab group decreased significantly, while there was no significant change in patients of Upadacitinib group. Although Upadacitinib group reported more adverse events than Dupilumab group, no serious adverse events were observed.

Conclusions

Both Upadacitinib and Dupilumab groups showed effective trend in patients with moderate to severe AD. Upadacitinib has better efficacy and rapid onset in the treatment of patients with moderate to severe AD.
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奥达帕替尼与杜比鲁单抗治疗中重度特应性皮炎的疗效比较:回顾性队列研究
背景虽然乌达替尼和杜比鲁单抗对中重度特应性皮炎(AD)的疗效和安全性已在临床试验中得到证实,但真实世界的数据仍然有限。这项回顾性研究旨在间接比较乌达替尼和杜比鲁单抗在实际应用中对中重度特应性皮炎患者的疗效和安全性。该研究纳入了2022年5月至2024年3月入组的中重度AD患者,以间接比较乌达替尼和杜匹鲁单抗在12周疗程内的疗效和安全性。结果共纳入87例患者(46例接受乌达替尼治疗,41例接受杜匹鲁单抗治疗)。与第0周相比,在第4、8和12周,两组患者的EASI评分、ADCT评分和NRS评分均显著下降。在第4周,乌达帕替尼组患者的EASI评分、ADCT评分和NRS评分的下降幅度明显高于杜比鲁单抗组患者。与基线相比,在第12周,乌达帕替尼组患者血清中IL-4、IL-13和IL-31水平的下降幅度明显高于杜比鲁单抗组。杜比鲁单抗组患者的总 IgE 水平明显下降,而乌达帕替尼组患者的总 IgE 水平无明显变化。虽然乌达帕替尼组比杜比鲁单抗组报告了更多的不良反应,但未观察到严重不良反应。乌达替尼治疗中重度AD患者的疗效更好,起效更快。
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来源期刊
CiteScore
8.40
自引率
3.60%
发文量
935
审稿时长
53 days
期刊介绍: International Immunopharmacology is the primary vehicle for the publication of original research papers pertinent to the overlapping areas of immunology, pharmacology, cytokine biology, immunotherapy, immunopathology and immunotoxicology. Review articles that encompass these subjects are also welcome. The subject material appropriate for submission includes: • Clinical studies employing immunotherapy of any type including the use of: bacterial and chemical agents; thymic hormones, interferon, lymphokines, etc., in transplantation and diseases such as cancer, immunodeficiency, chronic infection and allergic, inflammatory or autoimmune disorders. • Studies on the mechanisms of action of these agents for specific parameters of immune competence as well as the overall clinical state. • Pre-clinical animal studies and in vitro studies on mechanisms of action with immunopotentiators, immunomodulators, immunoadjuvants and other pharmacological agents active on cells participating in immune or allergic responses. • Pharmacological compounds, microbial products and toxicological agents that affect the lymphoid system, and their mechanisms of action. • Agents that activate genes or modify transcription and translation within the immune response. • Substances activated, generated, or released through immunologic or related pathways that are pharmacologically active. • Production, function and regulation of cytokines and their receptors. • Classical pharmacological studies on the effects of chemokines and bioactive factors released during immunological reactions.
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