Upadacitinib shows promise for long-term AD treatment

Upadacitinib with topical corticosteroids (TCS) shows good long-term efficacy and safety in patients with moderate-to-severe atopic dermatitis (AD), reports a recent follow-up analysis to the AD Up study.

AD Up, a phase III, randomized, double-blind, placebo-controlled study assigned 901 chronic AD patients to receive 15-mg upadacitinib (n=300), 30-mg upadacitinib (n=297), or placebo (n=304), all given once-daily and in combination with TCS.

The present study reported 52-week outcomes, including the co-primary efficacy endpoints of the proportion of patients who experienced ≥75-percent improvement in the Eczema Area and Severity Index (EASI-75) and the proportion who experienced ≥2 grades of improvement in the validated Investigator’s Global Assessment of AD (vIGA-AD 0/1).

EASI-75 occurred in 50.8 percent and 69.0 percent of patients who received the 15-mg and 30-mg upadacitinib doses, respectively; vIGA-AD 0/1, in comparison, was reported in 33.5 percent and 45.2 percent, respectively. Of note, 13.1 percent and 23.6 percent of the respective groups achieved EASI-100.

Moreover, both the 15-mg (least mean squares [LSM], –67.7 percent, 95 percent confidence interval [CI], –71.0 to –64.3) and the 30-mg (LSM, –77.4 percent, 95 percent CI, –80.8 to –74.0) induced significant reductions in EASI score relative to baseline.

Both doses of upadacitinib showed good tolerability profiles throughout 52 weeks of observation, and showed comparable exposure-adjusted event rate for all adverse events. Acne, nasopharyngitis, atopic dermatitis, and upper respiratory tract infections were common treatment-emergent adverse events. One patient dropped out due to side effects, while no deaths were reported.