Correction of psychoemotional disorders and quality of life in patients with eczema using janus kinase inhibitor

Objective. To evaluate the effectiveness of upadacitinib for improving the quality of life and correcting psycho-emotional disorders in patients with eczema.

Material and methods. The study included 64 patients with eczema (mean age 58.5 ± 3.4 years, men – 43, women – 21), randomized into two groups. Patients of group 1 (n = 33) received basic drug therapy (BDT), group 2 (n = 31) – in addition to BDT, the Janus kinase 1 inhibitor upadacitinib (UPA) 15 mg per day for 2 months. The values of the patients' dermatological symptom scale index (DISS), Dermatology Life Quality Index (DLQI), anxiety, depression, functional state of patients on the WAM (wellbeing, activity, mood) scale were evaluated in dynamics after 2 months after the start of treatment.

Results. In the BDT group, the value of DISS in patients after 2 months from the start of treatment decreased by 1.33 times, while in the UPA + BMT group it decreased by 2.17 times. In the BDT group, the DLQI index decreased by 1.26 times, while in the UPA + BDT group – by 1.66 times. The level of anxiety in patients in the BDT group decreased by 1.34 times, in the UPA + BDT group – by 1.64 times. The level of depression in the BDT group decreased by 1.22 times, in the UPA + BDT group – by 1.67 times. Indicators of the functional state of the WAN scale in patients with BMT increased only by 1.06, 1.03, 1.05 times, and in the UPA + BMT group, respectively, 1.4, 1.5, 1.6 times.

Conclusions. BDT, while improving the clinical status of patients, at the same time has an insufficient corrective effect on the severity of anxiety, depression, WAM indicators and a reduced quality of life. Additional appointment of upadacitinib to patients was accompanied by a more pronounced positive effect on the levels of anxiety, depression, indicators of the functional state of patients, which contributed to an improvement in the quality of life compared to the results of BDT.

1. Kochergin N. G. Smirnova L. M. Dermatological quality of life as a psychosomatic symptom of dermatosis. Russian Journal of Skin and Venereal Diseases. 2006; (4): 11–15.

2. Norreslet L. B., Ebbehoj N. E., Ellikilde-Bonde J.P. et al. The impact of atopic dermatitis on work life: A systematic review. J Eur Acad Dermatol Venereol 2018; 32 (1): 23–38.

3. Hon K. L., Tsang Y. C., Poon T. C. et al. Predicting eczema severity beyond childhood. World J Pediatr 2016; 12 (1): 44–48.

4. Finlay A. Y. Quality of Life Survey. A. Y. Finlay. Exchange. 1994. P. 22–73.

5. Hongbo Y., Thomas C. L., Harrison M. A. et al. Translating the science of quality of life into practice: What do dermatology life quality index scores mean? J Invest Dermatol 2005; 125 (4): 659–664.

6. Patel K. R., Singam V., Vakharia P. P. et al. Measurement properties of three assessments of burden used in atopic dermatitis in adults. Br J Dermatol 2018; 180 (5): 1083–1089.

7. Le P. H., Vo T. Q., Nguyen N. H. Quality of life measurement alteration among Vietnamese: Impact and treatment benefit related to eczema. J Pak Med Assoc. 2019; 69 (Suppl 2) (6): S 49–S 56.

8. Sharova N. M. Some aspects of the pathogenesis and therapy of eczema. Consilium Medicum. Pediatrics. 2015; (3): 72–75.

9. Sukharev A. V. Patrushev A. V., Nazarov R. N., Gutka V. O. Possibilities of using new generation antidepressants for the correction of psychosomatic disorders in chronic dermatoses. effective pharmacotherapy. 2014; (19): 18–23.

10. Eczema. Clinical recommendations of the Russian Federation 2021. Electronic resource. Available at: https://diseases.medelement.com/disease/eczema-kp-rf-2021/16993

11. Adaskevich V. P. Dermatovenereology. M.: Med. Lit., 2019.

12. Kochergin N. G., Smirnova L. M. Quality of life of a patient with skin disease: A dermatological approach. Aesthetic Medicine. 2003; 2 (1): 18–21.

13. Tsung Anxiety Self-Rating Scale. Available at: https://psylab.info/Шкала_самооценки_тревоги_Цунга/Бланк. Date of access: 01/22/2023.

14. Tsung depression self-report scale. Available at: https://psylab.info/Шкала_самооценки_депрессии_Цунга/Тестовый_материал. Date of access: 01/22/2023.

15. Barkanova O. V. Methods for diagnosing the emotional sphere: A psychological workshop [series: Library of Actual Psychology]. Issue. 2. Krasnoyarsk: Litera-print, 2009. 237 p.

16. Orlov A. N. Probabilistic-statistical models of correlation and regression. Scientific journal of KubSAU. 2020; 160 (06): 1–33.

17. Novoseletskaya A. I. Evaluation of quality-of-life indicators as a criterion for the effectiveness of the treatment of patients with eczema. Journal of GrGMU. 2010; 2 (30): 165–167.

18. Yakushkina N. Yu., Silina L. V. Quality of life in patients with chronic idiopathic eczema and its change under the influence of complex treatment. Kursk scientific and practical bulletin ‘Man and His Health’. 2003; (3): 63–67.

19. Ahmed N., Chaudhary A., Tahir M. et al. A comparative study on effect of endogenous and exogenous eczema on quality of life. PAFMJ. 2019; 69 (6): 1330–1334.

20. Arabian E. R. Some skin symptoms and dermatoses as predictors of the psychological status of patients in cosmetology institutions. Rus. Magazine of Skin and Venereal Diseases. 2006; (4): 64–66.

21. Sukharev A. V., Nazarov R. N. Medical and psychological correction in a dermatological hospital. Rus. Magazine of Skin and Venereal Diseases. 2006; (4): 25–27.