Scholarlink

Introduction <p>Understanding how treatment responses evolve over time is essential for optimising therapeutic strategies in moderate-to-severe atopic dermatitis (AD). While clinical trials have demonstrated the efficacy of targeted therapies, real-world evidence describing longitudinal response trajectories remains limited. This study aimed to characterise temporal patterns of clinical response in patients with AD treated with dupilumab or upadacitinib in routine clinical practice.</p> Methods <p>A multicentre real-world observational study was conducted using data from the Italian AD-Landscape platform, a structured clinical database collecting longitudinal information on patients receiving advanced systemic therapies for AD. Adult patients initiating dupilumab or upadacitinib between July 2019 and January 2026 were included if baseline and at least week-4 assessments were available. Disease severity and patient-reported outcomes were evaluated using the Eczema Area and Severity Index (EASI), Investigator’s Global Assessment (IGA), Pruritus Numerical Rating Scale (P-NRS) and Sleep Numerical Rating Scale (S-NRS) at baseline and at weeks 4, 16, 36 and 52. Categorical response thresholds (EASI75, EASI90 and EASI100) and safety outcomes were analysed descriptively.</p> Results <p>A total of 2625 patients were included (dupilumab <i>n</i>=2085; upadacitinib <i>n</i>=540). Both treatments produced rapid and sustained improvements in clinician-reported and patient-reported outcomes throughout the 52-week follow-up. Mean EASI scores decreased from 25.6 ± 6.5 to 2.2 ± 2.9 in the dupilumab group and from 19.1 ± 9.2 to 2.9 ± 5.7 in the upadacitinib group at week 52, respectively. Upadacitinib demonstrated faster early response kinetics, whereas dupilumab showed a progressive accumulation of clinical benefit over time, resulting in convergence of response rates during long-term follow-up. Safety findings were consistent with known mechanism-specific profiles.</p> Conclusions <p>In this large real-world cohort, both dupilumab and upadacitinib provided substantial and sustained clinical improvements in moderate-to-severe AD. Distinct response kinetics were observed, with faster early responses with upadacitinib and progressively increasing responses with dupilumab, supporting a personalised approach to treatment selection in routine clinical practice.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Longitudinal Response Trajectories with Dupilumab or Upadacitinib in Moderate-to-Severe Atopic Dermatitis: A Multicentre Real-World Study: IL-AD (Italian Landscape Atopic Dermatitis)

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年5月29日

查看全文
  • Luca Potestio,
  • Cataldo Patruno,
  • Silvia Mariel Ferrucci,
  • Alessandra Narcisi,
  • Michela Ortoncelli,
  • Elena Pezzolo,
  • Piergiorgio Malagoli,
  • Giampiero Girolomoni,
  • Mario Bruno Guanti,
  • Mariateresa Rossi,
  • Andrea Carugno,
  • Massimo Gola,
  • Francesca Satolli,
  • Francesco Loconsole,
  • Flavia Manzo Margiotta,
  • Anna Balato,
  • Eustachio Nettis,
  • Anna Graziella Burroni,
  • Franco Rongioletti,
  • Paola Savoia,
  • Federica Veronese,
  • Giacomo Dal Bello,
  • Giovanni Paolino,
  • Maria Esposito,
  • Agostina Legori,
  • Anna Campanati,
  • Francesca Barei,
  • Martina Zussino,
  • Luigi Gargiulo,
  • Matteo Bianco,
  • Ruggero Cascio Ingurgio,
  • Francesca Gaiani,
  • Martina Maurelli,
  • Nicola Zerbinati,
  • Santo Raffaele Mercuri,
  • Simone Ribero,
  • Francesca di Vico,
  • Maddalena Napolitano

摘要

Introduction

Understanding how treatment responses evolve over time is essential for optimising therapeutic strategies in moderate-to-severe atopic dermatitis (AD). While clinical trials have demonstrated the efficacy of targeted therapies, real-world evidence describing longitudinal response trajectories remains limited. This study aimed to characterise temporal patterns of clinical response in patients with AD treated with dupilumab or upadacitinib in routine clinical practice.

Methods

A multicentre real-world observational study was conducted using data from the Italian AD-Landscape platform, a structured clinical database collecting longitudinal information on patients receiving advanced systemic therapies for AD. Adult patients initiating dupilumab or upadacitinib between July 2019 and January 2026 were included if baseline and at least week-4 assessments were available. Disease severity and patient-reported outcomes were evaluated using the Eczema Area and Severity Index (EASI), Investigator’s Global Assessment (IGA), Pruritus Numerical Rating Scale (P-NRS) and Sleep Numerical Rating Scale (S-NRS) at baseline and at weeks 4, 16, 36 and 52. Categorical response thresholds (EASI75, EASI90 and EASI100) and safety outcomes were analysed descriptively.

Results

A total of 2625 patients were included (dupilumab n=2085; upadacitinib n=540). Both treatments produced rapid and sustained improvements in clinician-reported and patient-reported outcomes throughout the 52-week follow-up. Mean EASI scores decreased from 25.6 ± 6.5 to 2.2 ± 2.9 in the dupilumab group and from 19.1 ± 9.2 to 2.9 ± 5.7 in the upadacitinib group at week 52, respectively. Upadacitinib demonstrated faster early response kinetics, whereas dupilumab showed a progressive accumulation of clinical benefit over time, resulting in convergence of response rates during long-term follow-up. Safety findings were consistent with known mechanism-specific profiles.

Conclusions

In this large real-world cohort, both dupilumab and upadacitinib provided substantial and sustained clinical improvements in moderate-to-severe AD. Distinct response kinetics were observed, with faster early responses with upadacitinib and progressively increasing responses with dupilumab, supporting a personalised approach to treatment selection in routine clinical practice.