Use of Upadacitinib to Treat Atopic Dermatitis Refractory to Dupilumab in Elderly Patients

Atopic dermatitis (AD) is a relapsing and remitting inflammatory skin disease that can significantly impair an individual’s quality of life. Elderly-onset AD is increasing in prevalence in developed countries, likely due to aging populations. When disease is refractory to both topical steroids and dupilumab (a systemic IL-4R α inhibitor), there remains a lack of guidelines for treatment in elderly populations. Herein, we describe the treatment of five elderly patients (≥ 65-years-old) with upadacitinib, a novel JAK-inhibitor that is rarely used in elderly patients due to the elevated risk of systemic side effects. In this report, we found that upadacitinib successfully treated these patients’ atopic dermatitis, with minimal adverse effects. Presently, all five patients continue with this treatment.