Real-World Effectiveness and Safety of Dupilumab, Tralokinumab, and Upadacitinib in Patients with Atopic Dermatitis: A 52-Week International, Multicenter Retrospective Cohort Study

作者：Tiago Torres, Jensen Yeung, Vimal H. Prajapati, Simone Ribero, Anna Balato, Angelo Valerio Marzano, Maria João Cruz, Maria João Lopes, Elizabeth Lazaridou, J.M. Carrascosa, José Miguel Alvarenga, Pedro Farinha, Bruno Kosa Lino Duarte, Mónica Munera‐Campos, Siddhartha Sood, Brian D. Rankin, Michela Ortoncelli, Stefano Caccavale, Silvia Mariel Ferrucci, Gilberto Pires da Rosa, A. Daponte, Gianmarco Silvi, Ketty Peris, Niccolò Gori, Francesca Prignano, Antonio Kolios, Pedro Herranz, Stamatios Gregoriou, Natalia Rompoti, Spyridon Gkalpakiotis, Andrea Chiricozzi · 发表于：Dermatology and Therapy · 年份：2025 · DOI：10.1007/s13555-025-01453-8 · 被引用次数：7 · 研究领域：Dermatology and Skin Diseases、Psoriasis: Treatment and Pathogenesis、Mast cells and histamine

INTRODUCTION: Evaluating the real-world effectiveness, safety, and tolerability of targeted biologic and non-biologic therapies in patients with atopic dermatitis (AD) treated in routine clinical practice remains crucial. In this international, multicenter, retrospective, comparative study we aimed to evaluate the 52-week effectiveness, safety, and tolerability of dupilumab, tralokinumab, and upadacitinib in patients with AD aged ≥ 12 years. METHODS: Effectiveness was assessed at weeks 16, 24, and 52 using Eczema Area and Severity Index (EASI) and itch Numerical Rating Scale (NRS) scores. Safety was measured via adverse events (AEs). RESULTS: A total of 1286 treatment courses were included: 62.5% received dupilumab, 24.3% received upadacitinib, and 13.1% received tralokinumab. Upadacitinib demonstrated higher effectiveness than dupilumab and tralokinumab across all time points and most evaluated outcomes both on the overall population and the biologic-/JAKi-naïve population, including stringent treatment targets such as EASI 90 response and combined EASI 90 + itch NRS 0/1 response. While upadacitinib demonstrated superior effectiveness, it was associated with a higher incidence of AEs, both leading to and not leading to treatment discontinuation, including thromboembolic events, lipid abnormalities, and hematologic abnormalities. In contrast, conjunctivitis was the most frequently observed AE among patients receiving biologics. CONCLUSION: This study provides a comprehensive ...