{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T06:00:11Z","timestamp":1793685611224,"version":"4.5.1"},"reference-count":40,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T00:00:00Z","timestamp":1705536000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Limited real-world data are available on upadacitinib drug survival in patients with atopic dermatitis (AD). Objectives: To investigate upadacitinib drug survival, and the reasons and predictors of drug discontinuation in AD patients. Methods: All consecutive patients aged 18\u201375 years, affected by moderate-to-severe AD, and treated with upadacitinib for more than 1 month at dermatological clinics were included during November 2020\u2013August 2023. Upadacitinib survival was investigated through Kaplan\u2013Meier survival analysis and the predictors through multivariable logistic regression analysis. Results: Overall, 325 adult AD patients (mean (SD) age, 38.6(15.6) years) had a 1-year and 1.5-year upadacitinib drug survival of 91.5% and 80.2%, respectively. The main reasons for drug discontinuation (25\/325, 7.7%) were adverse events (4.9%), including cutaneous or infectious diseases (1.5%), such as acne and herpes zoster; blood test changes (1.2%), including hypercholesterolemia, creatine phosphokinase or liver enzyme elevation, and lymphopenia; urinary or respiratory infections (0.9%); deep venous thrombosis (0.3%); malignancies (0.3%); loss of consciousness (0.3%); and arthralgias (0.3%); followed by ineffectiveness (0.6%). No specific characteristic was significantly associated with an increased risk of upadacitinib discontinuation. Conclusions: Our findings show that upadacitinib was effective in moderate-to-severe AD after more than 1 year of continuous treatment but point to the need for clinical and laboratory monitoring of patients.<\/jats:p>","DOI":"10.3390\/jcm13020553","type":"journal-article","created":{"date-parts":[[2024,1,18]],"date-time":"2024-01-18T06:41:22Z","timestamp":1705560082000},"page":"553","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Drug Survival of Upadacitinib and Predicting Factors of Discontinuation in Adult Patients Affected by Moderate-to-Severe Atopic Dermatitis: An Italian Multicenter Analysis"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0121-4812","authenticated-orcid":false,"given":"Elena","family":"Pezzolo","sequence":"first","affiliation":[{"name":"Dermatology Unit, Ospedale San Bortolo, 36100 Vicenza, Italy"},{"name":"Study Centre of the Italian Group for Epidemiologic Research in Dermatology (GISED), 24128 Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michela","family":"Ortoncelli","sequence":"additional","affiliation":[{"name":"Dermatology Clinic, Department of Medical Sciences, University of Turin, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia Mariel","family":"Ferrucci","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario Bruno","family":"Guanti","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Modena and Reggio Emilia, 41100 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donatella","family":"Schena","sequence":"additional","affiliation":[{"name":"Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37100 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3309-8190","authenticated-orcid":false,"given":"Maddalena","family":"Napolitano","sequence":"additional","affiliation":[{"name":"Department of Clinical Medicine and Surgery, University of Naples Federico II, 80131 Naples, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5101-159X","authenticated-orcid":false,"given":"Mariateresa","family":"Rossi","sequence":"additional","affiliation":[{"name":"Dermatology Department, University of Brescia, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caterina","family":"Foti","sequence":"additional","affiliation":[{"name":"Unit of Dermatology, Department of Precision and Regenerative Medicine and Jonian Area, University of Bari Aldo Moro, 70121 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0766-8524","authenticated-orcid":false,"given":"Domenico","family":"D\u2019Amico","sequence":"additional","affiliation":[{"name":"UOC Dermatologia, AOU \u201cR. Dulbecco\u201d, Ospedale \u2018A. Pugliese\u2019, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe Fabrizio","family":"Amoruso","sequence":"additional","affiliation":[{"name":"UOC Dermatologia, Azienda Ospedaliera Cosenza, 87100 Cosenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pietro","family":"Morrone","sequence":"additional","affiliation":[{"name":"UOC Dermatologia, Azienda Ospedaliera Cosenza, 87100 Cosenza, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0098-1406","authenticated-orcid":false,"given":"Simone","family":"Ribero","sequence":"additional","affiliation":[{"name":"Dermatology Clinic, Department of Medical Sciences, University of Turin, 10124 Turin, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Barei","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matteo","family":"Biagi","sequence":"additional","affiliation":[{"name":"Department of Dermatology, University of Modena and Reggio Emilia, 41100 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Enrico","family":"Pascucci","sequence":"additional","affiliation":[{"name":"Section of Dermatology and Venereology, Department of Medicine, University of Verona, 37100 Verona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8661-2822","authenticated-orcid":false,"given":"Cataldo","family":"Patruno","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Magna Graecia University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0935-7204","authenticated-orcid":false,"given":"Piergiacomo","family":"Calzavara Pinton","sequence":"additional","affiliation":[{"name":"Dermatology Department, University of Brescia, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Romita","sequence":"additional","affiliation":[{"name":"Unit of Dermatology, Department of Precision and Regenerative Medicine and Jonian Area, University of Bari Aldo Moro, 70121 Bari, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6051-1676","authenticated-orcid":false,"given":"Luigi","family":"Gargiulo","sequence":"additional","affiliation":[{"name":"Department of Biomedical Sciences, Humanitas University, 20090 Milan, Italy"},{"name":"Dermatology Unit, IRCCS Humanitas Research Hospital, 20089 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandra","family":"Narcisi","sequence":"additional","affiliation":[{"name":"Dermatology Unit, IRCCS Humanitas Research Hospital, 20089 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Naldi","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Ospedale San Bortolo, 36100 Vicenza, Italy"},{"name":"Study Centre of the Italian Group for Epidemiologic Research in Dermatology (GISED), 24128 Bergamo, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,1,18]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1038\/s41572-018-0001-z","article-title":"Atopic dermatitis","volume":"4","author":"Weidinger","year":"2018","journal-title":"Nat. Rev. Dis. Primers"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1284","DOI":"10.1111\/all.13401","article-title":"Epidemiology of atopic dermatitis in adults: Results from an international survey","volume":"73","author":"Barbarot","year":"2018","journal-title":"Allergy"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"2232","DOI":"10.1111\/all.15807","article-title":"Global, regional, and national burden of allergic disorders and their risk factors in 204 countries and territories, from 1990 to 2019; A systematic analysis for the Global Burden Disease Study","volume":"78","author":"Shin","year":"2023","journal-title":"Allergy"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1053","DOI":"10.1111\/all.14631","article-title":"Systemic treatments in the management of atopic dermatitis: A systematic review and meta-analysis","volume":"76","author":"Siegels","year":"2021","journal-title":"Allergy"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1111\/jdv.14891","article-title":"Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: Part I","volume":"32","author":"Wollenberg","year":"2018","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"850","DOI":"10.1111\/jdv.14888","article-title":"Consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) in adults and children: Part II","volume":"32","author":"Wollenberg","year":"2018","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2335","DOI":"10.1056\/NEJMoa1610020","article-title":"Two Phase 3 trials of dupilumab versus placebo in AD","volume":"375","author":"Simpson","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"266","DOI":"10.1016\/j.jdermsci.2019.02.002","article-title":"Efficacy and safety of dupilumab monotherapy in adults with moderate-to-severe atopic dermatitis: A pooled analysis of two phase 3 randomized trials (LIBERTY AD SOLO 1 and LIBERTY AD SOLO 2)","volume":"94","author":"Simpson","year":"2019","journal-title":"J. Dermatol. Sci."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e757","DOI":"10.1111\/jdv.18889","article-title":"Long-term drug survival of dupilumab and associated predictors in moderate-to-severe atopic dermatitis: A real-world prospective cohort study","volume":"37","author":"Pezzolo","year":"2023","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1530","DOI":"10.1016\/j.jaad.2020.02.029","article-title":"Evaluation of long-term efficacy, safety, and reasons for discontinuation of dupilumab for moderate to severe atopic dermatitis in clinical practice: A retrospective cohort study","volume":"82","author":"Jo","year":"2020","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"4592087","DOI":"10.1155\/2023\/4592087","article-title":"Dupilumab: Direct Cost and Clinical Evaluation in Patients with Atopic Dermatitis","volume":"2023","author":"Ferrari","year":"2023","journal-title":"Dermatol. Res. Pract."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1111\/bjd.19574","article-title":"Tralokinumab for moderate-to-severe atopic dermatitis: Results from two 52-week, randomized, double-blind, multicentre, placebo-controlled phase III trials (ECZTRA 1 and ECZTRA 2)","volume":"184","author":"Wollenberg","year":"2021","journal-title":"Br. J. Dermatol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"991","DOI":"10.1093\/ced\/llad153","article-title":"Treatment of severe atopic dermatitis with tralokinumab in clinical practice: Short-term effectiveness and safety results","volume":"48","author":"Herranz","year":"2023","journal-title":"Clin. Exp. Dermatol."},{"key":"ref_14","first-page":"11","article-title":"Survival, efficacy and safety of tralokinumab after 32 and 52\u2009weeks of treatment for moderate-to-severe atopic dermatitis in adults: A multicenter real-world study","volume":"38","author":"Pezzolo","year":"2023","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1001\/jamadermatol.2022.3014","article-title":"Dupilumab drug survival and associated predictors in patients with moderate to severe atopic dermatitis: Long-term results from the daily practice BioDay registry","volume":"158","author":"Spekhorst","year":"2022","journal-title":"JAMA Dermatol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"418","DOI":"10.1111\/bjd.18179","article-title":"Effectiveness of dupilumab treatment in 95 patients with atopic dermatitis: Daily practice data","volume":"182","author":"Bosma","year":"2020","journal-title":"Br. J. Dermatol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1111\/ijd.14573","article-title":"Real-world experience of dupilumab treatment for atopic dermatitis in adults: A retrospective analysis of patients\u2019 records","volume":"59","author":"Wang","year":"2020","journal-title":"Int. J. Dermatol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"535","DOI":"10.1159\/000512890","article-title":"Successful combination of systemic agents for the treatment of atopic dermatitis resistant to dupilumab therapy","volume":"237","author":"Gori","year":"2021","journal-title":"Dermatology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"717","DOI":"10.1159\/000519361","article-title":"Therapeutic impact and management of persistent head and neck atopic dermatitis in dupilumab-treated patients","volume":"238","author":"Chiricozzi","year":"2021","journal-title":"Dermatology"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1016\/j.jaad.2021.01.012","article-title":"Facial and neck erythema associated with dupilumab treatment: A systematic review","volume":"84","author":"Jo","year":"2021","journal-title":"J. Am. Acad. Dermatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"450","DOI":"10.1111\/bjd.19573","article-title":"Tralokinumab plus topical corticosteroids for the treatment of moderate-to-severe atopic dermatitis: Results from the double- blind, randomized, multicentre, placebo- controlled phase III ECZTRA 3 trial","volume":"184","author":"Silverberg","year":"2021","journal-title":"Br. J. Dermatol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1111\/bjd.20810","article-title":"Conjunctivitis in adult patients with moderate-to-severe atopic dermatitis: Results from five tralokinumab clinical trials","volume":"186","author":"Wollenberg","year":"2022","journal-title":"Br. J. Dermatol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1080\/17425255.2022.2099835","article-title":"Pharmacodynamics of Janus kinase inhibitors for the treatment of atopic dermatitis","volume":"18","author":"Calabrese","year":"2022","journal-title":"Expert. Opin. Drug. Metab. Toxicol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1016\/j.jaci.2019.11.025","article-title":"Upadacitinib in adults with moderate to severe atopic dermatitis: 16-week results from a randomized, placebo-controlled trial","volume":"145","author":"Pangan","year":"2020","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"2151","DOI":"10.1016\/S0140-6736(21)00588-2","article-title":"Once-daily upadacitinib versus placebo in adolescents and adults with moderate-to-severe atopic dermatitis (Measure Up 1 and Measure Up 2): Results from two replicate double-blind, randomised controlled phase 3 trials","volume":"397","author":"Teixeira","year":"2021","journal-title":"Lancet"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"2169","DOI":"10.1016\/S0140-6736(21)00589-4","article-title":"Safety and efficacy of upadacitinib in combination with topical corticosteroids in adolescents and adults with moderate-to-severe atopic dermatitis (AD Up): Results from a randomised, double-blind, placebo-controlled, phase 3 trial","volume":"397","author":"Reich","year":"2021","journal-title":"Lancet"},{"key":"ref_27","first-page":"e361","article-title":"Upadacitinib effectiveness in moderate-to-severe atopic dermatitis: A real-life multicentre and retrospective study","volume":"64","year":"2023","journal-title":"Australas. J. Dermatol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e832","DOI":"10.1111\/jdv.18311","article-title":"Real-life experience of upadacitinib for the treatment of adult patients with moderate-to-severe atopic dermatitis\u2014A case series","volume":"36","author":"Feraru","year":"2022","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_29","first-page":"211","article-title":"Treatment of severe atopic dermatitis with upadacitinib in real clinical practice. Short-term efficacy and safety results","volume":"33","author":"Herranz","year":"2022","journal-title":"J. Investig. Allergol. Clin. Immunol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1007\/s40268-022-00396-1","article-title":"Effectiveness and safety of upadacitinib in the treatment of moderate-severe atopic dermatitis: A multicentric, prospective, real-world, cohort study","volume":"22","author":"Chiricozzi","year":"2022","journal-title":"Drugs RD"},{"key":"ref_31","first-page":"1","article-title":"Drug survival studies in dermatology: Principles, purposes, and pitfalls","volume":"135","author":"Kievit","year":"2015","journal-title":"J. Investig. Dermatol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"953","DOI":"10.1007\/s40257-023-00798-0","article-title":"Long-term Effectiveness and Safety of Upadacitinib for Atopic Dermatitis in a Real-world Setting: An Interim Analysis Through 48 Weeks of Observation","volume":"24","author":"Chiricozzi","year":"2023","journal-title":"Am. J. Clin. Dermatol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"2242543","DOI":"10.1080\/09546634.2023.2242543","article-title":"Retreatment with upadacitinib in atopic dermatitis: Experience in clinical practice","volume":"34","author":"Batalla","year":"2023","journal-title":"J. Dermatol. Treat."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1007\/s13555-022-00721-1","article-title":"Comparative Efficacy of Targeted Systemic Therapies for Moderate to Severe Atopic Dermatitis without Topical Corticosteroids: Systematic Review and Network Meta-analysis","volume":"12","author":"Silverberg","year":"2022","journal-title":"Dermatol. Ther."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"adv00402","DOI":"10.2340\/00015555-3751","article-title":"Treat-to-target in atopic dermatitis: An international consensus on a set of core decision points for systemic therapies","volume":"101","author":"Biedermann","year":"2021","journal-title":"Acta Derm. Venereol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1001\/jamadermatol.2022.0029","article-title":"Efficacy and Safety of Upadacitinib in Patients with Moderate to Severe Atopic Dermatitis: Analysis of Follow-up Data from the Measure Up 1 and Measure Up 2 Randomized Clinical Trials","volume":"158","author":"Simpson","year":"2022","journal-title":"JAMA Dermatol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1634","DOI":"10.1111\/jdv.18995","article-title":"Higher levels of response on clinical atopic dermatitis severity measures are associated with meaningful improvements in patient-reported symptom and quality of life measures: Integrated analysis of three Upadacitinib phase 3 trials","volume":"37","author":"Reich","year":"2023","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1016\/j.jaci.2022.09.023","article-title":"Safety of upadacitinib in moderate-to-severe atopic dermatitis: An integrated analysis of phase 3 studies","volume":"151","author":"Thyssen","year":"2023","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Gargiulo, L., Ibba, L., Piscazzi, F., Alfano, A., Cascio Ingurgio, R., Valenti, M., Costanzo, A., and Narcisi, A. (2023). Effectiveness and safety of upadacitinib for moderate-to-severe atopic dermatitis in a real-world setting: A 52-week retrospective study. J. Eur. Acad. Dermatol. Venereol.","DOI":"10.1111\/jdv.19507"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"2509","DOI":"10.1007\/s12325-023-02490-5","article-title":"Real-Life Effectiveness and Tolerance of Upadacitinib for Severe Atopic Dermatitis in Adolescents and Adults","volume":"40","author":"Ghislain","year":"2023","journal-title":"Adv. Ther."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/2\/553\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T13:49:37Z","timestamp":1760104177000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/2\/553"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,18]]},"references-count":40,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2024,1]]}},"alternative-id":["jcm13020553"],"URL":"https:\/\/doi.org\/10.3390\/jcm13020553","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,18]]}}}