Upadacitinib for Refractory Paediatric Atopic Dermatitis: A Real‐World Study on Effectiveness and Safety in Dupilumab Nonresponders.

This article discusses the effectiveness and safety of upadacitinib, a selective JAK1 inhibitor, for pediatric patients with moderate-to-severe atopic dermatitis (AD) who did not respond to dupilumab treatment. The study included 12 patients aged 6-14 who had failed conventional topical corticosteroid treatment and had a history of poor response to dupilumab. Significant improvements were observed in various clinical endpoints, including Eczema Area and Severity Index (EASI), Numerical Rating Scale (NRS), and Children's Dermatology Life Quality Index (CDLQI). Adverse events were generally mild, with acne being the most common. Infections were reported in 25% of patients, highlighting a potential risk for younger patients. One serious adverse event of appendicitis was reported, although a direct causal relationship with upadacitinib remains unclear. Routine laboratory monitoring is important for detecting and managing adverse events. One patient developed vitiligo during treatment, which may be attributed to the common coexistence of AD and vitiligo rather than being an adverse effect of upadacitinib. The study acknowledges limitations such as the small sample size and lack of a control group, emphasizing the need for long-term follow-up to assess the sustained efficacy and safety of upadacitinib in pediatric patients. [Extracted from the article]