{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:59:15Z","timestamp":1790391555751,"version":"4.1.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:00:00Z","timestamp":1790380800000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Palmoplantar pustulosis (PPP) is a rare, disabling inflammatory skin disease with substantial unmet need. Janus kinase inhibitors (JAKi) target inflammatory pathways implicated in PPP. High smoking prevalence and rare disease status mean that a randomised controlled trial (RCT) to evaluate the efficacy and safety of JAKi in PPP may be challenging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To determine the feasibility of a future RCT of JAKi therapy in PPP and generate an exploratory estimate of treatment effect.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This open-label, assessor-blinded feasibility trial, conducted at a UK national specialist dermatology centre, enrolled adults (\u226518\u2005years) with moderate-to-severe PPP and treated them with upadacitinib 30\u2005mg once daily for 8 weeks (15\u2005mg for higher-risk individuals). Primary feasibility endpoints were recruitment (consent rate), adherence (\u226580% of days covered), and acceptability (\u2018completely acceptable\u2019\/\u2019acceptable\u2019 on post-treatment 5-point Likert scale). Secondary outcomes included change from baseline in Palmoplantar Pustulosis-Psoriasis Area and Severity Index (PP-PASI) and safety. Study procedures were harmonised with a previous RCT in PPP, permitting comparison with historic placebo data. Analyses were descriptive with baseline-adjusted PP-PASI change estimated with a linear (Gaussian) mixed-effects model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>All prespecified feasibility criteria were met. Of 67 contacted individuals, 28 consented (41.8%), and 20 started treatment (71.4%; mean age 46.0\u2005years; 85% female). Adherence \u226580% was achieved by 19\/20 participants (95%), with a mean proportion of days covered of 95.7% (SD 9.7). 18\/19 participants (94.7%) viewed treatment as acceptable. Mean PP-PASI decreased from 20.3 (SD 10.6) at baseline to 4.6 (SD 4.5) at week 8 with upadacitinib, versus 18.0 (SD 10.4) to 15.4 (SD 10.1) with historic placebo. Baseline-adjusted PP-PASI change at week 8 for upadacitinib relative to historic placebo was \u221212.3 (95% CI \u221215.8 to \u22128.9) in favour of upadacitinib. PP-PASI50 and PP-PASI75 responses with upadacitinib relative to historic placebo were 100% vs 16.1% and 65.0% vs 3.2%. The most common adverse events were headache, acne, and upper respiratory tract infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This study demonstrates that a definitive trial of JAK inhibition in PPP is feasible and identifies an encouraging exploratory efficacy signal. The findings support progression to a multicentre active-comparator randomised controlled trial.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjd\/ljag410","type":"journal-article","created":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T11:15:35Z","timestamp":1789989335000},"source":"Crossref","is-referenced-by-count":0,"title":["Upadacitinib for Palmoplantar Pustulosis: An Open-label, Assessor-blinded Feasibility Study Using Historic Control Data (JAKPPPOT)"],"prefix":"10.1093","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7355-9281","authenticated-orcid":false,"given":"David","family":"Gleeson","sequence":"first","affiliation":[{"name":"St. John's Institute of Dermatology, King's College London, Guy\u2019s Hospital , Great Maze Pond, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Chapman","sequence":"additional","affiliation":[{"name":"Centre for Adherence Research and Education, King\u2019s College London , Stamford Street, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neville","family":"Qin","sequence":"additional","affiliation":[{"name":"St. John's Institute of Dermatology, Guy's & St. Thomas\u2019 NHS Foundation Trust, Guy\u2019s Hospital , Great Maze Pond, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Gregory","sequence":"additional","affiliation":[{"name":"St. John's Institute of Dermatology, Guy's & St. Thomas\u2019 NHS Foundation Trust, Guy\u2019s Hospital , Great Maze Pond, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Mitchell-Gears","sequence":"additional","affiliation":[{"name":"St. John's Institute of Dermatology, Guy's & St. Thomas\u2019 NHS Foundation Trust, Guy\u2019s Hospital , Great Maze Pond, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jade","family":"Pizzato","sequence":"additional","affiliation":[{"name":"St. John's Institute of Dermatology, Guy's & St. Thomas\u2019 NHS Foundation Trust, Guy\u2019s Hospital , Great Maze Pond, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kingsley","family":"Powell","sequence":"additional","affiliation":[{"name":"St. John's Institute of Dermatology, Guy's & St. Thomas\u2019 NHS Foundation Trust, Guy\u2019s Hospital , Great Maze Pond, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manpreet K","family":"Sagoo","sequence":"additional","affiliation":[{"name":"St. John's Institute of Dermatology, Guy's & St. Thomas\u2019 NHS Foundation Trust, Guy\u2019s Hospital , Great Maze Pond, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weiyu","family":"Ye","sequence":"additional","affiliation":[{"name":"St. John's Institute of Dermatology, Guy's & St. Thomas\u2019 NHS Foundation Trust, Guy\u2019s Hospital , Great Maze Pond, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"Moorhead","sequence":"additional","affiliation":[{"name":"St. John's Institute of Dermatology, Guy's & St. Thomas\u2019 NHS Foundation Trust, Guy\u2019s Hospital , Great Maze Pond, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan","family":"Barker","sequence":"additional","affiliation":[{"name":"St. John's Institute of Dermatology, Guy's & St. Thomas\u2019 NHS Foundation Trust, Guy\u2019s Hospital , Great Maze Pond, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1230-2781","authenticated-orcid":false,"given":"James","family":"Galloway","sequence":"additional","affiliation":[{"name":"Centre for Rheumatic Diseases, Weston Education Centre, King\u2019s College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helen","family":"McAteer","sequence":"additional","affiliation":[{"name":"Psoriasis Association , 2 Queensbridge, Northampton ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Woolf","sequence":"additional","affiliation":[{"name":"St. John's Institute of Dermatology, Guy's & St. Thomas\u2019 NHS Foundation Trust, Guy\u2019s Hospital , Great Maze Pond, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew E","family":"Pink","sequence":"additional","affiliation":[{"name":"St. John's Institute of Dermatology, Guy's & St. Thomas\u2019 NHS Foundation Trust, Guy\u2019s Hospital , Great Maze Pond, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6113-1173","authenticated-orcid":false,"given":"Suzie","family":"Cro","sequence":"additional","affiliation":[{"name":"Imperial Clinical Trials Unit, Imperial College London, Stadium House , 68 Wood Lane, White City, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satveer","family":"Mahil","sequence":"additional","affiliation":[{"name":"St. John's Institute of Dermatology, Guy's & St. Thomas\u2019 NHS Foundation Trust, Guy\u2019s Hospital , Great Maze Pond, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Smith","sequence":"additional","affiliation":[{"name":"St. John's Institute of Dermatology, King's College London, Guy\u2019s Hospital , Great Maze Pond, London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,9,26]]},"container-title":["British Journal of Dermatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/bjd\/advance-article-pdf\/doi\/10.1093\/bjd\/ljag410\/71400092\/ljag410.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/bjd\/advance-article-pdf\/doi\/10.1093\/bjd\/ljag410\/71400092\/ljag410.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T02:08:27Z","timestamp":1790388507000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/bjd\/advance-article\/doi\/10.1093\/bjd\/ljag410\/8836368"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,26]]},"references-count":0,"URL":"https:\/\/doi.org\/10.1093\/bjd\/ljag410","relation":{},"ISSN":["0007-0963","1365-2133"],"issn-type":[{"value":"0007-0963","type":"print"},{"value":"1365-2133","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,26]]},"article-number":"ljag410"}}