Clinical Response to Upadacitinib in Treatment-Experienced Patients With Atopic Dermatitis: A Case Series From Latin America.
4 affiliations
- 1Dermatology, Hospital San Javier, Guadalajara, MEX.
- 2Pediatric Dermatology, Hospital Civil de Guadalajara, Guadalajara, MEX.
- 3Dermatology, Dermika Centro Dermatológico Láser, Guadalajara, MEX.
- 4Dermatology, Antiguo Hospital Civil de Guadalajara "Fray Antonio Alcalde", Guadalajara, MEX.
Abstract
Atopic dermatitis (AD) is a chronic inflammatory skin disease that may require systemic therapy in patients with persistent disease activity or an inadequate response to previous treatments. Upadacitinib, a selective Janus kinase 1 inhibitor, has demonstrated rapid clinical efficacy in patients with moderate-to-severe AD; however, real-world data from Latin American populations remain limited. We describe the clinical responses and treatment outcomes of five adult patients with AD from Mexico who received oral upadacitinib after previous treatment with topical and/or systemic therapies. Clinical response was assessed using the Eczema Area and Severity Index (EASI), Numerical Rating Scale (NRS) for pruritus, and Dermatology Life Quality Index (DLQI) at baseline and week 2, with subsequent follow-up ranging from six months to two years. Four patients initiated upadacitinib 15 mg once daily, whereas one initially received 30 mg once daily and was subsequently reduced to 15 mg because of elevated liver enzyme levels. At week 2, all five patients experienced clinical improvement, with EASI reductions ranging from 40% to 54.5%, NRS reductions of 50-80%, and DLQI scores decreasing to 1-3. All patients maintained clinical improvement during follow-up and ultimately achieved an EASI score ≤3 and a DLQI score of 0. Notably, two patients who had previously experienced disease relapse during dupilumab treatment demonstrated marked improvement after switching to upadacitinib. One patient developed elevated liver enzyme levels approximately 1.5 times the upper limit of normal, which resolved after dose reduction; no other adverse events were reported. These cases highlight the potential role of upadacitinib in treatment-experienced patients with AD, including those with disease relapse following dupilumab treatment. Larger prospective studies are needed to further evaluate its effectiveness and safety in Latin American populations.
Related
- Long-term upadacitinib treatment in a patient with atopic dermatitis, bullous pemphigoid, and alopecia areata: a case report and review of the literature
- Long-Term Disease Control During Continuous Treatment with Upadacitinib and Baricitinib for Moderate-to-Severe Atopic Dermatitis: a Real-World Monocentric Retrospective Study
- Subcorneal Pustular Dermatosis as a Complication of Upadacitinib Therapy in a Patient with Atopic Dermatitis: A Case Report
- Explorative Correlation of Atopic Dermatitis Control Tool with Minimal Disease Activity Patient-reported Outcomes in Patients Treated with Upadacitinib: A Retrospective Real-world Study
- Upadacitinib in refractory acquired reactive perforating collagenosis with atopic dermatitis and chronic kidney disease: a case report.
BibTeX
@article{sandoval2026clinical,
title = {{Clinical Response to Upadacitinib in Treatment-Experienced Patients With Atopic Dermatitis: A Case Series From Latin America.}},
author = {Ana B Crocker Sandoval and Yocelin N Lozano Figueroa and Ana G Perez-Romero and Alan O Muro-Davalos},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.118166},
url = {https://europepmc.org/article/MED/42899233},
note = {CC BY},
}
RIS
TY - JOUR
TI - Clinical Response to Upadacitinib in Treatment-Experienced Patients With Atopic Dermatitis: A Case Series From Latin America.
AU - Ana B Crocker Sandoval
AU - Yocelin N Lozano Figueroa
AU - Ana G Perez-Romero
AU - Alan O Muro-Davalos
PY - 2026
DA - 2026/10/19
JO - Cureus
DO - 10.7759/cureus.118166
UR - https://europepmc.org/article/MED/42899233
AB - Atopic dermatitis (AD) is a chronic inflammatory skin disease that may require systemic therapy in patients with persistent disease activity or an inadequate response to previous treatments. Upadacitinib, a selective Janus kinase 1 inhibitor, has demonstrated rapid clinical efficacy in patients with moderate-to-severe AD; however, real-world data from Latin American populations remain limited. We describe the clinical responses and treatment outcomes of five adult patients with AD from Mexico who received oral upadacitinib after previous treatment with topical and/or systemic therapies. Clinical response was assessed using the Eczema Area and Severity Index (EASI), Numerical Rating Scale (NRS) for pruritus, and Dermatology Life Quality Index (DLQI) at baseline and week 2, with subsequent follow-up ranging from six months to two years. Four patients initiated upadacitinib 15 mg once daily, whereas one initially received 30 mg once daily and was subsequently reduced to 15 mg because of elevated liver enzyme levels. At week 2, all five patients experienced clinical improvement, with EASI reductions ranging from 40% to 54.5%, NRS reductions of 50-80%, and DLQI scores decreasing to 1-3. All patients maintained clinical improvement during follow-up and ultimately achieved an EASI score ≤3 and a DLQI score of 0. Notably, two patients who had previously experienced disease relapse during dupilumab treatment demonstrated marked improvement after switching to upadacitinib. One patient developed elevated liver enzyme levels approximately 1.5 times the upper limit of normal, which resolved after dose reduction; no other adverse events were reported. These cases highlight the potential role of upadacitinib in treatment-experienced patients with AD, including those with disease relapse following dupilumab treatment. Larger prospective studies are needed to further evaluate its effectiveness and safety in Latin American populations.
SN - 2168-8184
ER -