Study: AD Patients Switching From Dupilumab to Upadacitinib Have Improved EASI, Itch Scores

Treatment of moderate-to-severe atopic dermatitis (AD) with upadacitinib in patients who received dupilumab for 16 weeks without an adequate response demonstrated improved efficacy in skin and itch endpoints, according to new research.

“Switching from Dupilumab to Upadacitinib in Adults and Adolescents with Moderate-to-Severe Atopic Dermatitis and Inadequate Response to Dupilumab: Efficacy and Safety Results from the Phase 3b/4 LEVEL UP Study” was authored by Christopher G. Bunick, MD, FAAD; Nina Magnolo, MD; Angela Moore, MD; Gao Xinghua, MD, PhD; Charles Lynde, MD; Nadia Ibrahim, MD; Ayman Grada, MD; Gweneth Levy, MD, FAAP; Brian Calimlim, MS; Xiaoqiang Wu, MD, PhD; Yolanda Armendariz; and Kilian Eyerich, MD, PhD.

Among 355 patients entering Period 2 of the LEVEL UP study, 208 received dupilumab in Period 1 and switched to upadacitinib in Period 2. Of those 208 patients, 79.6% achieved eczema area and severity index (EASI) 75, 58.7% achieved EASI 90, and 19.9% achieved EASI 100, with responses seen as early as 4 weeks after switching. Most of those patients also achieved improvements in measures of itch.

No new safety signals were observed after switching from dupilumab to upadacitinib without a washout period, and safety findings for upadacitinib were consistent with the known safety profile, with no new safety signals identified.

“These findings indicate that [upadacitinib] may address an unmet need in patients with moderate-to-severe AD who do not achieve an adequate response while taking [dupilumab],” the authors concluded.