Beneficial effects of upadacitinib on a subgroup of patients with atopic dermatitis and hidradenitis suppurativa: a multicenter, real-world retrospective study

Introduction: Although AD and HS are significantly different clinically, they share common systemic comorbidities and some immunological pathways. The aim of this multicentric Italian retrospective study is to assess therapeutic effects of upadacitinib on concomitant HS in AD patients. Materials and methods: Multicentric, observational, real-life retrospective study on 195 patients with moderate to severe AD treated with upadacitinib. Specifically, a subgroup analysis of AD+HS patients was conducted. Demographic, clinical data, outcome measures (EASI, NRS itch, sleep and pain, DLQI POEM and ADCT) were collected at baseline (week 0) and at subsequent time points (week 4, week 16, week 32, and week 52). Additionally, IHS4 IHS4-55 and HiSCR were the tools used to evaluate the clinical course of HS in the AD+HS subgroup. Results: A total of 195 AD patients were included, 7 (3,6%) patients also suffered of concomitant HS. In the AD+HS subgroup, mean IHS4 decreased from 6.9 ± 4.3 at baseline to 2.2 ± 1.8 at week 16 and 0.2 ± 0.5 at week 32. Reductions of mean baseline severity of HS tool (IHS4) score was detected as early as after only 4 weeks of treatment. Accordingly, HiSCR and HIS4-S5 were achieved by 4/7 patients at week 4, 5/6 at week 16, and 4/4 at week 32. Discussion: In the AD+HS subgroup, improvements were observed for both AD and HS-specific outcomes. Our data, although preliminary, show that upadacitinib could be a valid therapeutic choice in the treatment of patients with AD and concomitant HS.