TUESDAY, Aug. 22, 2023 -- For patients with moderate-to-severe atopic dermatitis (AD), clinical responses are maintained with continuous upadacitinib through 40 weeks, and outcomes are improved for patients who switch from dupilumab to upadacitinib, according to a study published in the September issue of the Journal of the American Academy of Dermatology.

Andrew Blauvelt, M.D., from Oregon Medical Research Center in Portland, and colleagues examined the long-term safety and efficacy of continuous upadacitinib 30 mg and switching to upadacitinib after dupilumab treatment for 24 weeks. The study included adults who completed the phase 3b clinical trial of oral upadacitinib 30 mg versus injectable dupilumab 300 mg (Heads Up), who entered a 52-week open-label extension (OLE). During the OLE, all patients received 30 mg upadacitinib. The researchers reported the results of a prespecified interim 16-week extension period.

The researchers found that high levels of skin and itch response were reported for 239 patients continuing upadacitinib. Additional incremental improvements in clinical responses were seen within four weeks of starting upadacitinib for the 245 patients switching from dupilumab. Of those who did not achieve clinical responses with dupilumab, most did so with upadacitinib. In up to 40 weeks (16 weeks of OLE), the safety profile of upadacitinib was consistent with previous phase 3 studies, and there were no new safety events.

"Upadacitinib provides greater efficacy compared with dupilumab, has a favorable benefit-risk profile, and patients regardless of prior dupilumab response status experienced improved outcomes when switched to upadacitinib," the authors write.

Several authors disclosed ties to the pharmaceutical industry, including AbbVie, which funded the clinical trials included in this analysis.