Experience of using the drug upadacitinib in a child with severe atopic dermatitis

Abstract

Introduction. Atopic dermatitis (AtD) is a genetically determined chronic dermatosis with heterogeneous manifestations that can significantly affect the quality of life of patients. The disease has a complex pathogenesis, which significantly complicates its treatment. The JAK-STAT signaling pathway plays a central role in the modulation of several immune axes involved in the immunopathogenesis of AtD. In particular, the action of Th2 cytokines, including IL-4, IL-5, IL-13, IL-31 and thymus stromal lymphopoietin, is mediated by transmission of the JAK-STAT signal, which makes this pathway a good target for targeted drugs.

Presentation of the clinical case. At the present stage, the problem of choosing tactics for the treatment of severe forms of ATD is important. In June 2021, the drug upadacitinib, a selective reversible type 1 janus kinase inhibitor, was registered in the Russian Federation for the treatment of moderate to severe AtD in adults and children 12 years and older. This publication presents our own successful experience of using upadacitinib in the form of a description of a clinical case in a 16-year-old child with uncontrolled severe AtD. Before the drug was prescribed, the patient’s disease course was continuously recurrent, with severe exacerbations and short periods of remission, as well as resistance to standard therapy.

Conclusion. The use of upadacitinib at a dose of 15 mg for 11 months allowed the teenager to achieve rapid remission of the disease and successfully control such a complex symptom as itching.