Atopic Dermatitis and Ulcerative Colitis Successfully Treated with Upadacitinib

Background and Objectives: JAK inhibitors entered current clinical practice as treatment for several immune-related diseases and, recently, for atopic dermatitis. These drugs target the Janus Kinase intracellular cascade, rendering them suitable for treating both Th1 and Th2 immune-mediated responses. Materials and Methods: We report the case of a 36-year-old male patient presenting an overlap of ulcerative colitis, a Th1-related disease, and atopic dermatitis, a Th2-mediated condition. Treatment with upadacitinib was initiated, and laboratory and instrumental follow-ups were carried out for 8 months. Results: The complete and persistent clinical remission of both conditions was observed at a low dose of 15 mg of upadacitinib, even though ulcerative colitis guidelines usually recommend a dosage of 45 mg. No serious adverse responses to therapy were reported. Conclusions: Upadacitinib may be the most suitable management strategy in subjects with coexisting severe conditions mediated by Th1 inflammation, such as ulcerative colitis, and by Th2 cytokines, such as atopic dermatitis.

Automated summary

JAK inhibitors have shown efficacy in treating immune-related diseases such as ulcerative colitis and atopic dermatitis. This case report demonstrates the successful management of a patient with overlapping conditions of ulcerative colitis and atopic dermatitis using upadacitinib, resulting in complete and persistent clinical remission. These findings suggest that upadacitinib may be an optimal treatment strategy for individuals with coexisting Th1 and Th2-mediated conditions.