Supplementary Material for: Upadacitinib monotherapy in vitiligo associated with atopic dermatitis: killing two birds with one stone

Introduction: An increased risk of developing vitiligo has recently been described in patients with atopic dermatitis (AD). Vitiligo and AD can be associated because of shared pathogenetic pathways, including alterations in the Janus kinases/signal transducer and activator of transcription (JAK/STAT) signaling, suggesting JAK inhibitors as a promising new therapeutic approach in vitiligo. Case Presentation: We describe a 25-year-old woman diagnosed with AD since childhood and subsequent onset of slowly progressive vitiligo at the age of 16. Systemic therapy with JAK1 inhibitor upadacitinib 15 mg daily was started, after a medical and laboratory evaluation to exclude pregnancy and other contraindications. Progressive improvement of AD was observed after the first weeks of treatment with clinical remission at week-16. At the same time, clear improvement of vitiligo was observed with an almost complete remission achieved at week-28 of treatment. Conclusion: The remission of both AD and vitiligo achieved with upadacitinib monotherapy supports the therapeutic utility of inhibition of JAK 1 signaling in these patients.

引言：近期已有研究报道，特应性皮炎（atopic dermatitis, AD）患者罹患白癜风（vitiligo）的风险显著升高。白癜风与AD存在关联，二者共享多条致病通路，其中包括Janus激酶/信号转导与转录激活因子（Janus kinases/signal transducer and activator of transcription, JAK/STAT）信号通路异常改变，这提示Janus激酶抑制剂（JAK inhibitors）可作为白癜风极具潜力的新型治疗方案。
病例报告：本研究报告1例自幼确诊为特应性皮炎（AD）的25岁女性患者，其于16岁时出现缓慢进展的白癜风。经全面医学与实验室检查排除妊娠及其他禁忌证后，予患者每日口服15mg Janus激酶1（JAK1）抑制剂乌帕替尼（upadacitinib）进行系统性治疗。治疗最初几周后即可观察到特应性皮炎症状逐步改善，至第16周时实现临床缓解。与此同时，白癜风症状亦出现明显改善，治疗至第28周时几乎达到完全缓解。
结论：采用乌帕替尼（upadacitinib）单药治疗即可使AD与白癜风均达到缓解，这一结果证实了抑制JAK1信号通路对该类患者的治疗价值。