Efficacy and Safety of Upadacitinib Versus Dupilumab Treatment for Moderate to Severe Atopic Dermatitis in Four Body Regions: Analysis From the Heads-Up Study.

IF 3 3区医学 Q2 DERMATOLOGY Dermatology Pub Date : 2024-10-30 DOI:10.1159/000542275

Jacob P Thyssen, David Rosmarin, Antonio Costanzo, Richard Warren, Chia-Yu Chu, Raj Chovatiya, Barry Ladizinski, Xiaofei Hu, Yingyi Liu, Brian Calimlim, Chudi Nduaka, Namita Vigna, April Armstrong

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Abstract

Introduction: Upadacitinib has demonstrated high and rapid rates of efficacy in adolescent and adult patients with moderate-to-severe atopic dermatitis (AD) as assessed by the Eczema Area and Severity Index (EASI). This post hoc analysis assessed the EASI response in four anatomical regions for patients with moderate-to-severe AD treated with upadacitinib compared to dupilumab over 24 weeks.

Methods: Data from patients randomised 1:1 to receive upadacitinib 30 mg extended-release tablet orally once daily or dupilumab 300 mg by subcutaneous injection every 2 weeks after a loading dose of 600 mg in the Heads Up study were analysed for achievement of ≥75%, ≥90%, or 100% reduction of EASI in four body regions: 1) head and neck, 2) trunk (including genitals), 3) upper limbs, and 4) lower limbs (including buttocks) at each study visit through week 24. Patient response data from the Head and Neck Patient Global Impression of Severity (HN-PGIS) were also analysed at each study visit for comparison of upadacitinib to dupilumab.

Results: Greater proportions of patients treated with upadacitinib versus dupilumab achieved skin clearance rates of ≥75% (EASI 75) at week 1 and higher clearance rates of ≥90% (EASI 90) or 100% (EASI 100) by week 4 or earlier in all four body regions. This difference was maintained at each visit through week 24 for both EASI 90 and EASI 100. Patient responses on the HN-PGIS indicated that a greater proportion of patients (nominal p-value <0.05) treated with upadacitinib compared to dupilumab reported that AD symptoms in the head and neck region were absent or minimal as early as week 1.

Conclusion: Compared to dupilumab, upadacitinib treatment provided higher rates of rapid, sustained efficacy for the head and neck, trunk, upper limbs, and lower limbs for the treatment of moderate-to-severe AD as measured by the EASI and supported by patient responses.

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乌达帕替尼与杜匹单抗治疗四个身体部位中度至重度特应性皮炎的有效性和安全性：抬头研究分析

简介：根据湿疹面积和严重程度指数（EASI）评估，奥达帕替尼对中重度特应性皮炎（AD）青少年和成人患者的疗效显著且见效快。这项事后分析评估了中重度特应性皮炎患者在接受达达替尼与杜比鲁单抗治疗24周后四个解剖区域的EASI反应：在 "抬起头来 "研究中，患者按1:1比例随机接受达帕替尼30毫克缓释片，每天口服一次，或在600毫克负荷剂量后每2周皮下注射一次杜比鲁单抗300毫克：在第 24 周之前的每次研究访问中，对以下四个身体部位的 EASI 降低情况进行分析：1）头颈部；2）躯干（包括生殖器）；3）上肢；4）下肢（包括臀部）。在每个研究访问中，还分析了来自头颈部患者严重程度总体印象（HN-PGIS）的患者反应数据，以比较upadacitinib和dupilumab：与杜比鲁单抗相比，接受达帕替尼治疗的患者在第1周皮肤清除率≥75%（EASI 75）的比例更高，在第4周或更早时，所有四个身体区域的皮肤清除率≥90%（EASI 90）或100%（EASI 100）的比例更高。EASI 90 和 EASI 100 的这一差异在每次就诊时都会保持到第 24 周。患者对HN-PGIS的反应表明，有更大比例的患者（名义p值结论）在第4周或更早达到100%（EASI 100）：与杜比鲁单抗相比，奥达替尼治疗中重度AD在头颈部、躯干、上肢和下肢的快速、持续疗效率更高，这可以通过EASI来衡量，并得到患者反应的支持。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dermatology 医学-皮肤病学

CiteScore

6.40

自引率

2.90%

发文量

审稿时长

1 months

期刊介绍： Published since 1893, ''Dermatology'' provides a worldwide survey of clinical and investigative dermatology. Original papers report clinical and laboratory findings. In order to inform readers of the implications of recent research, editorials and reviews prepared by invited, internationally recognized scientists are regularly featured. In addition to original papers, the journal publishes rapid communications, short communications, and letters to ''Dermatology''. ''Dermatology'' answers the complete information needs of practitioners concerned with progress in research related to skin, clinical dermatology and therapy. The journal enjoys a high scientific reputation with a continually increasing impact factor and an equally high circulation.