Upadacitinib Shows Superior Skin Clearance in Head and Neck Atopic Dermatitis Compared to Dupilumab

A numerically higher proportion of patients receiving upadacitinib achieved Eczema Area and Severity Index (EASI) 75/90/100 in the head and neck as early as 2 weeks after treatment was initiated compared with those receiving dupilumab in new Level Up study data presented at the 2025 American Academy of Dermatology (AAD) Annual Meeting in Orlando, Florida.

The poster “Higher Levels of Skin Clearance Across Body Regions with Upadacitinib versus Dupilumab in Patients with Moderate-to-Severe Atopic Dermatitis” was presented by Killian Eyerich, MD, PhD; Tiago Torres, MD, PhD; Charles W Lynde, FRCPC; Christopher Bunick, MD, PhD, FAAD; Angela Moore, MD; Namita Vigna; Brian Calimlim, MS; Xiaoqiang Wu, MD, PhD; Nadia Ibrahim, MD; Cristina Sancho, and Jonathan Silverberg, MD, PhD, MPH.

At Week 2, 28.5% of patients using upadacitinib had reached EASI 75 in the head and neck, 15.3% had reached EASI 90, and 9.1% had reached EASI 100; among patients on dupilumab at Week 2, those numbers were 13.5%, 7.9%, and 5.2%. At Week 16, 51.8% of patients using upadacitinib had reached EASI 75 in the head and neck, 38.1% had reached EASI 90, and 27.6% had reached EASI 100; among patients on dupilumab at Week 16, those numbers were 40.0%, 26.5%, and 19.3%.

Additionally, among patients who switched from dupilumab to upadacitinib at Week 16, achievement of EASI 75/90/100 in the head and neck improved, reach 66.7%, 46.5%, and 32.7%, respectively, by Week 32.

“Beginning at Week 2, across all body regions, a numerically higher proportion of patients receiving upadacitinib, compared to dupilumab, achieved EASI 75/90/100,” the authors concluded. “Numerically higher EASI 75/90/100 response rates were maintained through Week 16 across all body regions compared with dupilumab. Among dupilumab inadequate responders (EASI <75), switching to upadacitinib resulted in higher rates of EASI 90/100 across all body regions; improvements were noted beginning at Week 20 and maintained through Week 32.”