Department of Dermatology, Nippon Medical School Chiba Hokusoh Hospital, Inzai, Japan.
Department of Dermatology, Nippon Medical School, Tokyo, Japan.
J Dermatol. 2023 Oct;50(10):1301-1312. doi: 10.1111/1346-8138.16879. Epub 2023 Jul 3.
Upadacitinib, an oral Janus kinase 1 inhibitor approved for treating atopic dermatitis (AD), can cause adverse events such as herpes zoster (HZ) and acne. We aimed to identify background factors predicting the occurrence of HZ and acne during upadacitinib treatment in patients with AD. From August 2021 to December 2022, 112 Japanese patients with moderate-to-severe AD (aged ≥12 years) were treated with upadacitinib 15 mg/day (78 patients) or 30 mg/day (34 patients) plus topical corticosteroids or delgocitinib limited to head and neck for 3-9 months. AD patients with the occurrence of HZ during upadacitinib treatment had higher incidences for history of HZ and of bronchial asthma than those without in the upadacitinib 15 mg, 30 mg, and whole groups. AD patients with occurrence of HZ had higher pretreatment values of lactate dehydrogenase and eczema area and severity index on head and neck compared to those without in the upadacitinib 15 mg and whole groups. Logistic regression analysis revealed that history of HZ was associated with the occurrence of HZ in the upadacitinib 15 mg and whole groups. The proportion of underage patients (<18 years) was higher in patients with occurrence of acne compared to those without in the upadacitinib 30 mg group, but no significant differences were found in the other background factors between the two patient populations. History of HZ may predict the occurrence of HZ during upadacitinib treatment in patients with AD.
巴瑞替尼是一种口服 JAK1 抑制剂，已获批用于治疗特应性皮炎（AD），可引起带状疱疹（HZ）和痤疮等不良反应。我们旨在确定 AD 患者接受巴瑞替尼治疗期间发生 HZ 和痤疮的预测因素。2021 年 8 月至 2022 年 12 月，112 例中重度 AD（≥12 岁）日本患者接受巴瑞替尼 15mg/天（78 例）或 30mg/天（34 例）治疗，联合局部皮质类固醇或仅限于头颈部的地奈德治疗 3-9 个月。与未发生 HZ 的患者相比，接受巴瑞替尼治疗期间发生 HZ 的 AD 患者中，有 HZ 病史和支气管哮喘病史的发生率更高。与未发生 HZ 的患者相比，在接受巴瑞替尼治疗的 15mg 和整体组中，发生 HZ 的 AD 患者的乳酸脱氢酶和头颈部 Eczema Area and Severity Index（EASI）预治疗值更高。logistic 回归分析显示，巴瑞替尼 15mg 和整体组中，HZ 病史与 HZ 的发生相关。与未发生痤疮的患者相比，发生痤疮的患者中未成年患者（<18 岁）比例更高，但在其他背景因素方面，两组患者之间没有显著差异。AD 患者的 HZ 病史可能预测其接受巴瑞替尼治疗期间 HZ 的发生。
