WEDNESDAY, March 12, 2025 -- For adult patients with moderate-to-severe atopic dermatitis (AD), upadacitinib (UPA) 15 mg and 30 mg are both efficacious for achievement and maintenance of an optimal clinical target of improvement of more than 90 percent in the Eczema Area and Severity Index (EASI90), according to a study presented at the annual meeting of the American Academy of Dermatology, held from March 7 to 11 in Orlando, Florida.

Melinda Gooderham, M.D., from the SKiN Centre for Dermatology in Peterborough, Ontario, Canada, and colleagues examined the efficacy and safety of two treatment approaches with UPA based on achievement of EASI90 in adults with moderate-to-severe AD. A total of 461 participants were randomly assigned to receive UPA 15 or 30 mg during a 12-week double-blind period (229 and 232 patients, respectively). At week 12, UPA 15-mg nonresponders were dose-escalated to UPA 30 mg (UPA15/30mg), while responders continued on UPA 15 mg (UPA15/15mg); UPA 30-mg nonresponders continued on UPA 30 mg (UPA30/30mg), while responders switched to UPA 15 mg (UPA30/15mg).

The researchers found that at week 24, 48.1 and 29.3 percent of UPA15/30mg and UPA30/30mg, respectively, achieved EASI90 at week 24, while 68.5 and 74.6 percent of those on UPA30/15mg and UPA15/15mg, respectively, maintained EASI90. Overall, 20.7 and 35.0 percent of the UPA15/30mg and UPA30/15mg cohorts, respectively, achieved combined EASI90 with Worst Pruritus Numerical Rating Scale (WP-NRS) 0/1 at week 24; 32.5 and 38.0 percent achieved WP-NRS 0/1; and 24.0 and 35.4 percent achieved Dermatology Life Quality Index 0/1. Treatment-emergent adverse events were reported in 43.1, 54.2, 61.5, and 48.9 percent of the UPA15/15mg, UPA15/30mg, UPA30/30mg, and UPA30/15mg cohorts, respectively.

"Both UPA treatment approaches demonstrate achievement and maintenance of EASI90," the authors write. "Overall safety findings were consistent with the known UPA safety profile, with no new safety signals identified."

The study was funded by AbbVie, the manufacturer of upadacitinib.