Kiefer Sebastian, König Anke, Gerger Viviane, Rummenigge Christine, Müller Anne Christine, Jung Thomas, Frank Alexandra, Tassopoulos Georgios, Laurent Emilie, Kaufmann Roland, Pinter Andreas
Department of Dermatology, Venereology and Allergology, University Hospital of Frankfurt, 60590 Frankfurt am Main, Germany.
J Clin Med. 2023 Feb 1;12(3):1175. doi: 10.3390/jcm12031175.
For the treatment of moderate-to-severe atopic dermatitis in children and adolescents, the monoclonal antibody dupilumab and the selective JAK-1 inhibitor upadacitinib are two modern systemic therapies approved for long-term treatment. Both drugs have demonstrated high efficacy in randomized controlled trials, although evidence from real-world data in the pediatric population is limited. In a prospective analysis over 24 weeks, we investigated the efficacy, safety and treatment satisfaction of both systemic therapies in 23 patients (16 patients treated with dupilumab; 7 patients treated with upadacitinib). The median age of the patients was 16 years, with a median EASI of 18.8. A significant improvement in the EASI, VAS-itch, CDLQI, POEM and DFIQ from baseline to week 24 was demonstrated for both treatment options. No significant difference was observed between dupilumab and upadacitinib in any of the assessed scores. Less adverse events were recorded in the real-world setting compared with clinical trials. Our results confirm the efficacy and safety of dupilumab and upadacitinib as equivalent treatment options in children and adolescents in a real-world setting.
对于儿童和青少年中重度特应性皮炎的治疗，单克隆抗体度普利尤单抗和选择性JAK-1抑制剂乌帕替尼是两种获批用于长期治疗的现代全身疗法。两种药物在随机对照试验中均显示出高疗效，尽管儿科人群真实世界数据的证据有限。在一项为期24周的前瞻性分析中，我们调查了这两种全身疗法在23例患者（16例接受度普利尤单抗治疗；7例接受乌帕替尼治疗）中的疗效、安全性和治疗满意度。患者的中位年龄为16岁，中位湿疹面积和严重程度指数（EASI）为18.8。两种治疗方案均显示从基线到第24周EASI、视觉模拟评分法瘙痒（VAS-itch）、儿童皮肤病生活质量指数（CDLQI）、患者导向湿疹测量（POEM）和皮肤病治疗功能指数（DFIQ）有显著改善。在任何评估分数中，度普利尤单抗和乌帕替尼之间均未观察到显著差异。与临床试验相比，在真实世界中记录到的不良事件较少。我们的结果证实了度普利尤单抗和乌帕替尼在真实世界中作为儿童和青少年等效治疗方案的疗效和安全性。
