Long-Term Disease Control During Continuous Treatment with Upadacitinib and Baricitinib for Moderate-to-Severe Atopic Dermatitis: a Real-World Monocentric Retrospective Study
- 1Department of Biomedical Sciences, Humanitas University, 20072 Pieve Emanuele, MI Italy
- 2Dermatology Unit, IRCCS Humanitas Research Hospital, 20089 Rozzano, Italy
Abstract
Introduction: Real-world evidence on long-term effectiveness and safety of oral Janus kinase (JAK) inhibitors in atopic dermatitis (AD) remains limited. This study evaluated sustained long-term clinical and patient-reported disease control and safety during continuous treatment with upadacitinib 30 mg or baricitinib 4 mg.
Methods: This monocentric retrospective study included adults with moderate-to-severe AD treated at IRCCS Humanitas Research Hospital. Eligible patients had baseline assessments and completed longitudinal follow-ups while remaining on their assigned JAK inhibitor. Outcomes were assessed through week 260 for upadacitinib and week 312 for baricitinib and included Eczema Area and Severity Index (EASI) 75/90/100, EASI ≤ 7/≤ 3, Investigator Global Assessment (IGA) 0/1, mean EASI, Peak Pruritus Numerical Rating Scale (PP-NRS), Sleep Disturbance Numerical Rating Scale (SD-NRS) improvement and remission endpoints, and safety. Between-treatment comparisons were considered exploratory only.
Results: The long-term cohort included 41 patients: 34 received upadacitinib and 7 baricitinib. At week 260, EASI 75, EASI 90, EASI ≤ 7, and EASI ≤ 3 were achieved by 97.1%, 91.2%, 100.0%, and 91.2% of upadacitinib-treated patients, respectively. In the baricitinib group, EASI 75 was maintained by all patients from week 32 to week 312, and EASI 90, EASI ≤ 7, and EASI ≤ 3 were achieved by all patients at week 312. IGA 0/1 and mean EASI indicated sustained low disease activity during follow-up. At week 260, ΔPP-NRS ≥ 4 and ΔSD-NRS ≥ 4 were maintained in 82.4% and 73.5% of upadacitinib-treated patients and in 85.7% and 71.4% of baricitinib-treated patients, with corresponding baricitinib rates maintained at week 312. Adverse events were infrequent, with no serious adverse events, treatment interruptions, or permanent discontinuations in the long-term cohort.
Conclusions: In selected patients remaining on continuous treatment, upadacitinib and baricitinib were associated with sustained long-term clinical and patient-reported control of moderate-to-severe AD. Larger prospective studies are needed to clarify outcomes after dose reduction or discontinuation and the potential for deeper disease remodeling.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s13555-026-01940-6.
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BibTeX
@article{doria2026longterm,
title = {{Long-Term Disease Control During Continuous Treatment with Upadacitinib and Baricitinib for Moderate-to-Severe Atopic Dermatitis: a Real-World Monocentric Retrospective Study}},
author = {Francesco D’Oria and Costanza Falcidia and Giulio Foggi and Matteo Bianco and Ruggero Cascio Ingurgio and Angela Alfano and Luciano Ibba and Mario Valenti and Antonio Costanzo and Alessandra Narcisi and Luigi Gargiulo},
journal = {Dermatology and Therapy},
year = {2026},
month = oct,
doi = {10.1007/s13555-026-01940-6},
url = {https://doi.org/10.1007/s13555-026-01940-6},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Long-Term Disease Control During Continuous Treatment with Upadacitinib and Baricitinib for Moderate-to-Severe Atopic Dermatitis: a Real-World Monocentric Retrospective Study
AU - Francesco D’Oria
AU - Costanza Falcidia
AU - Giulio Foggi
AU - Matteo Bianco
AU - Ruggero Cascio Ingurgio
AU - Angela Alfano
AU - Luciano Ibba
AU - Mario Valenti
AU - Antonio Costanzo
AU - Alessandra Narcisi
AU - Luigi Gargiulo
PY - 2026
DA - 2026/10/01
JO - Dermatology and Therapy
DO - 10.1007/s13555-026-01940-6
UR - https://doi.org/10.1007/s13555-026-01940-6
AB - Introduction: Real-world evidence on long-term effectiveness and safety of oral Janus kinase (JAK) inhibitors in atopic dermatitis (AD) remains limited. This study evaluated sustained long-term clinical and patient-reported disease control and safety during continuous treatment with upadacitinib 30 mg or baricitinib 4 mg. Methods: This monocentric retrospective study included adults with moderate-to-severe AD treated at IRCCS Humanitas Research Hospital. Eligible patients had baseline assessments and completed longitudinal follow-ups while remaining on their assigned JAK inhibitor. Outcomes were assessed through week 260 for upadacitinib and week 312 for baricitinib and included Eczema Area and Severity Index (EASI) 75/90/100, EASI ≤ 7/≤ 3, Investigator Global Assessment (IGA) 0/1, mean EASI, Peak Pruritus Numerical Rating Scale (PP-NRS), Sleep Disturbance Numerical Rating Scale (SD-NRS) improvement and remission endpoints, and safety. Between-treatment comparisons were considered exploratory only. Results: The long-term cohort included 41 patients: 34 received upadacitinib and 7 baricitinib. At week 260, EASI 75, EASI 90, EASI ≤ 7, and EASI ≤ 3 were achieved by 97.1%, 91.2%, 100.0%, and 91.2% of upadacitinib-treated patients, respectively. In the baricitinib group, EASI 75 was maintained by all patients from week 32 to week 312, and EASI 90, EASI ≤ 7, and EASI ≤ 3 were achieved by all patients at week 312. IGA 0/1 and mean EASI indicated sustained low disease activity during follow-up. At week 260, ΔPP-NRS ≥ 4 and ΔSD-NRS ≥ 4 were maintained in 82.4% and 73.5% of upadacitinib-treated patients and in 85.7% and 71.4% of baricitinib-treated patients, with corresponding baricitinib rates maintained at week 312. Adverse events were infrequent, with no serious adverse events, treatment interruptions, or permanent discontinuations in the long-term cohort. Conclusions: In selected patients remaining on continuous treatment, upadacitinib and baricitinib were associated with sustained long-term clinical and patient-reported control of moderate-to-severe AD. Larger prospective studies are needed to clarify outcomes after dose reduction or discontinuation and the potential for deeper disease remodeling. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1007/s13555-026-01940-6.
SN - 2193-8210
SN - 2190-9172
ER -