{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T20:03:42Z","timestamp":1783454622770,"version":"3.55.0"},"reference-count":16,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100006483","name":"AbbVie","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006483","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Journal of Dermatology"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Upadacitinib (UPA) is a selective Janus kinase 1 inhibitor that improves moderate\u2010to\u2010severe atopic dermatitis, but real\u2010world strategies to maintain remission after response remain unclear. We conducted a multicenter retrospective study in Japan of 219 patients aged \u2265\u200912\u2009years who achieved protocol\u2010defined remission, defined as Investigator's Global Assessment (IGA) 0\/1 at two visits \u2265\u20094\u2009weeks apart during UPA treatment. Patients were classified as on\u2010label (continuous daily 15 or 30\u2009mg), spacing\/reduction (extension of the dosing interval and\/or dose\u2010reduction after remission), or discontinuation (stopping UPA after remission). The primary endpoint was maintenance of remission over 48\u2009weeks; secondary endpoints were time to relapse, outcomes after treatment modification, remission at 72\u2009weeks after \u2265\u200924\u2009weeks of sustained remission, and safety. Because the analysis was restricted to responders who achieved remission, generalizability to all UPA\u2010treated patients is limited. Seventy\u2010five percent of patients achieved IGA 0\/1 within about 4\u2009months of starting UPA. Over the subsequent 48\u2009weeks, 127\/200 (63.5%, 95% CI 56.6\u201369.9) maintained IGA 0\/1. When stratified by post\u2010remission dosing strategy (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009193; excluding 7 who switched to other systemic therapy), remission at 48\u2009weeks was maintained in 93\/145 (64.1%, 95% CI 55.8\u201371.9) in the on\u2010label group, 24\/32 (75.0%, 95% CI 56.6\u201388.5) in the spacing\/reduction group, and 6\/16 (37.5%, 95% CI 15.2\u201364.6) in the discontinuation group. Among patients with \u2265\u200924\u2009weeks of sustained remission, week\u201072 IGA 0\/1 maintenance rates were 70.7% (95% CI 60.7\u201379.1;\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009107), 100% (95% CI 63.1\u2013100.0;\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20098), and 60.0% (95% CI 20.0\u201390.0;\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20095) in the on\u2010label, spacing\/reduction, and discontinuation groups, respectively; estimates for spacing\/reduction and discontinuation were imprecise due to small sample sizes. Longer on\u2010label treatment before tapering or discontinuation tended to be associated with a lower relapse risk. UPA showed a safety profile consistent with previous studies. Acne, herpes simplex, herpes zoster, and folliculitis were the most frequent adverse events, and most were mild and manageable, although one herpes zoster case required temporary interruption. In this responder\u2010enriched real\u2010world Japanese cohort, UPA induced remission in most patients within 4\u2009months and allowed approximately two\u2010thirds to maintain remission over 48\u2009weeks. Observed outcomes suggest that maintaining on\u2010label dosing and cautious spacing\/reduction after sustained remission may help preserve disease control, whereas discontinuation may be associated with a higher risk of relapse; however, comparisons between dosing strategies are descriptive and hypothesis\u2010generating. Prospective studies are needed to confirm these findings.\n                  <\/jats:p>","DOI":"10.1111\/1346-8138.70299","type":"journal-article","created":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T04:43:03Z","timestamp":1780634583000},"page":"980-989","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real\u2010World Maintenance of Remission in Atopic Dermatitis Patients With Upadacitinib: A Multicenter Retrospective Study in Japan (\n                    <scp>ROADMAP<\/scp>\n                    Study)"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3590-6489","authenticated-orcid":false,"given":"Yuichiro","family":"Tsunemi","sequence":"first","affiliation":[{"name":"Department of Dermatology Saitama Medical University  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5903-3187","authenticated-orcid":false,"given":"Atsuyuki","family":"Igarashi","sequence":"additional","affiliation":[{"name":"Igarashi Dermatology Higashigotanda  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-4491-9947","authenticated-orcid":false,"given":"Takeshi","family":"Ishido","sequence":"additional","affiliation":[{"name":"Medical Affairs AbbVie GK  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1095-0355","authenticated-orcid":false,"given":"Hidehisa","family":"Saeki","sequence":"additional","affiliation":[{"name":"Department of Dermatology Nippon Medical School  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/1346-8138.17544"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2017.12.022"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaci.2021.08.009"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2021.3023"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjd\/ljae404"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00588-2"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamadermatol.2022.0029"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s13555-024-01157-5"},{"key":"e_1_2_13_10_1","volume-title":"Guidelines for the Promotion of Optimal Use of Upadacitinib (UPA)","author":"Ministry of Health, Labour and Welfare","year":"2023"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2020.04.104"},{"key":"e_1_2_13_12_1","volume-title":"RINVOQ (Upadacitinib) Package Insert","author":"AbbVie GK","year":"2025"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)00589-4"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/bjd\/ljaf236"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jaad.2021.05.075"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/jdv.19391"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1093\/ced\/llae410"}],"container-title":["The Journal of 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