To evaluate the efficacy and safety of upadacitinib in patients with immune drift.
Approach:
Study Design: A single-center, prospective observational cohort study conducted at the First Affiliated Hospital of Guangxi Medical University.
Participants: Eleven patients with immune drift (8 PSO-AD and 3 AD-PSO) were recruited.
Treatment: Patients received oral upadacitinib as monotherapy for four weeks.
Outcome Measures: Primary efficacy was assessed by the proportion of patients achieving IGA 0/1, with secondary measures including EASI and PASI scores.
Key Findings:
62.5% of patients achieved IGA 0/1 response after four weeks.
EASI scores decreased from 18.0 (12.4–24.4) to 2.5 (0.52–13.1) (p = 0.0059). EASI-75 and EASI-90 response rates were 63.64% and 45.5%, respectively.
PASI scores declined from 9.4 (7.4–10.2) to 2.8 (1.85–4.05) (p = 0.001). PASI-75 and PASI-90 response rates were 45.45% and 18.18%, respectively.
Quality of life improved, with DLQI scores reducing from 21.8 ± 1.75 to 9.3 ± 8.92 (p = 0.0012).
No severe adverse events were reported; only one case of folliculitis (9.1%).
Interpretation:
Upadacitinib demonstrated efficacy and safety in managing immune drift, with significant improvements in disease control and quality of life.
Limitations:
Small sample size of 11 patients.
Lack of a control group.
Short duration of follow-up (four weeks).
Conclusion:
Upadacitinib appears effective and safe for managing immune drift in patients with psoriasis and atopic dermatitis.
