This paper analyzes the safety of upadacitinib, a JAK inhibitor medication, across multiple autoimmune conditions including atopic dermatitis. It looks at data from clinical trials to understand potential side effects and risks of the medication.

The researchers analyzed data from 12 clinical trials that studied upadacitinib in different conditions. They tracked adverse events (side effects) that occurred during treatment and calculated how frequently these events happened. They compared the safety of upadacitinib to other treatments like adalimumab and methotrexate.

For atopic dermatitis specifically, the study included 2,693 patients (both adults and adolescents aged 12 and older) with moderate-to-severe disease. These patients were treated with either 15mg or 30mg daily doses of upadacitinib for up to 2.75 years.

For atopic dermatitis patients, the most common side effect with 30mg upadacitinib was acne, though this was usually mild and rarely led to stopping treatment. The higher 30mg dose had more side effects overall compared to the 15mg dose. Serious infections were rare, occurring in less than 1 per 100 patient-years. Three deaths occurred in the 30mg group, with two related to COVID-1

The authors conclude that upadacitinib was generally well-tolerated in atopic dermatitis patients with no unexpected safety concerns identified. Some variations in side effects were observed between different diseases, likely due to differences in patient populations and disease-related factors. They note that longer follow-up is still needed to fully understand long-term safety.