Beneficial effects of upadacitinib on a subgroup of patients with atopic dermatitis and hidradenitis suppurativa: a multicenter, real-world retrospective study

TL;DR

This study shows that upadacitinib can help patients with both atopic dermatitis and hidradenitis suppurativa, improving symptoms in both conditions.

Contribution

The study is the first to report the beneficial effects of upadacitinib on hidradenitis suppurativa in patients with atopic dermatitis in a real-world setting.

Findings

Upadacitinib significantly reduced hidradenitis suppurativa symptoms in patients with atopic dermatitis as early as week 4.

Improvements in both atopic dermatitis and hidradenitis suppurativa outcomes were observed over 52 weeks of treatment.

Most patients achieved significant hidradenitis suppurativa improvement scores by week 16.

Abstract

Although AD and HS are significantly different clinically, they share common systemic comorbidities and some immunological pathways. The aim of this multicentric Italian retrospective study is to assess therapeutic effects of upadacitinib on concomitant HS in AD patients.

Multicentric, observational, real-life retrospective study on 195 patients with moderate to severe AD treated with upadacitinib. Specifically, a subgroup analysis of AD+HS patients was conducted. Demographic, clinical data, outcome measures (EASI, NRS itch, sleep and pain, DLQI POEM and ADCT) were collected at baseline (week 0) and at subsequent time points (week 4, week 16, week 32, and week 52). Additionally, IHS4 IHS4–55 and HiSCR were the tools used to evaluate the clinical course of HS in the AD+HS subgroup.

A total of 195 AD patients were included, 7 (3,6%) patients also suffered of concomitant HS. In the AD+HS subgroup, mean IHS4 decreased from 6.9 ± 4.3 at baseline to 2.2 ± 1.8 at week 16 and 0.2 ± 0.5 at week 32. Reductions of mean baseline severity of HS tool (IHS4) score was detected as early as after only 4 weeks of treatment. Accordingly, HiSCR and HIS4-S5 were achieved by 4/7 patients at week 4, 5/6 at week 16, and 4/4 at week 32.

In the AD+HS subgroup, improvements were observed for both AD and HS-specific outcomes. Our data, although preliminary, show that upadacitinib could be a valid therapeutic choice in the treatment of patients with AD and concomitant HS.

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