JAK inhibitor provides sustained skin clearance in adolescents and adults with AD

Upadacitinib therapy led to robust clinical efficacy and itch relief in adolescents and adults with moderate-to-severe atopic dermatitis in 3 ongoing phase 3 trials.

Efficacy results: sustained from week 16 up to week 140

Dr Jonathan Silverberg (The George Washington University School of Medicine and Health Sciences, Washington DC, USA) presented the week 140 data of 3 ongoing randomised, double-blind, multicentre phase 3 studies (Measure Up 1 NCT03569293, Measure Up 2 NCT03607422, and AD UP NCT03568318)1. In these trials, adolescents and adults with moderate-to-severe AD were randomised to receive upadacitinib in 2 doses (15 mg and 30 mg) or placebo once daily. At week 16, placebo-treated participants were re-randomised to receive upadacitinib in either of 2 doses. 

All efficacy results were sustained from week 16 up to week 140: in the 4 groups (upadacitinib 15 mg, upadacitinib 30 mg, placebo/upadacitinib 15 mg, and placebo/upadacitinib 30 mg) EASI75 responses were achieved by 83.5% up to 89.4% of participants. In addition, between 60.4% (placebo/upadacitinib 15 mg) and 75.5% (placebo/upadacitinib 30 mg) gained clear or almost clear skin according to the assessment of the investigators.

Sustained itch relief

“The EASI90 responses show a similar result,” Dr Silverberg said. Participants treated with placebo in the double-blind phase achieved similar results after the switch to upadacitinib compared with those receiving upadacitinib continuously.

The JAK1 inhibitor also led to a sustained itch relief. At week 140, between 68.0% and 81.3% of participants achieved a ≥4-point reduction on the Worst Pruritus Metric Rating Scale. 

“Safety is especially important long time. Overall, we see there is a slightly higher rate of adverse events in the higher dose group, such as for serious infection herpes zoster and acne – but the rates are overall low and consistent with data we had in previous data sets,” Dr Silverberg said.

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  1. Silverberg J, et al. Efficacy and safety of upadacitinib through 140 weeks in adolescents and adults with moderate-to-severe atopic dermatitis: phase 3 randomized clinical trial results. D1T01.1B, EADV Congress 2023, 11–14 October, Berlin, Germany.