By week 16, most patients with moderate to severe atopic dermatitis taking upadacitinib either had a 90 percent disease clearance, or even 100 percent disease clearance.

Upadacitinib yields rapid and significant improvements in patients with moderate to severe atopic dermatitis, according to results from two phase 3 clinical trials published online in The Lancet.

Patients who received upadacitinib showed reductions in all clinical disease measures, as well as in all itch-related outcomes and there were no unexpected safety signals.

“The results of these trials (Measure Up 1 and Measure Up 2) were so incredible that by week 16, most patients with moderate to severe atopic dermatitis either had a 90 percent disease clearance, or even 100 percent disease clearance,” says Emma Guttman-Yassky, MD, PhD, Waldman Professor and Chair of the Kimberly and Eric J. Waldman Department of Dermatology, Icahn School of Medicine at Mount Sinai, and first author of the paper, in a news release.

“We achieved extremely high clearance rates that are bringing us closer to the amazing clearance rates that we see in psoriasis,” says Dr. Guttman-Yassky. “Also, the itch improvements already started to be significant within days from the beginning of the trials, and the maximum clinical efficacy was obtained early, at week 4, and maintained to week 16.” 

If you look at what each of the JAK inhibitors are targeting, JAK1 tackles the important cytokines in atopic dermatitis — IL-13, IL-4, IL-31, and IL-22 — and that’s why we’ve seen amazing results in atopic dermatitis,” she says.

She also noted that upadacitinib was well tolerated by patients in the two highest doses of the drug—15 mg and 30mg—and no important safety risks were observed.  

 “The results achieved with this study were very impressive and provided robust efficacy,” shares Dr. Guttman-Yassky. “Patients were able to start and restart the oral medication at any time, allowing for flexibility, which cannot be achieved with biologics.”

While biologics have been very successful for treating patients with atopic dermatitis for whom topical treatments have not worked or are not advised, Dr. Guttman-Yassky explains that they cannot be stopped and restarted at will because of a potential to create anti-drug antibodies, which will shorten the half-life of the drug.

Additionally, Dr. Guttman-Yassky noted that the study also provides the opportunity for adolescents and adult patients who fear injections the option of taking an oral systemic medication for their disease and is an alternative for those suffering from moderate to severe atopic dermatitis. "Right now, we have dupilumab, which is an amazing drug that has utterly changed the landscape of the disease. However not everybody responds to it, and because it’s an injectable medication, it’s not suitable for all patients,” she says.  

The Measure Up 1 study took place between August 13, 2018, and December 23, 2019, and 847 patients were enrolled. The Measure Up 2 study took place between July 27, 2018, and January 17, 2020, and 836 patients were enrolled. The study was funded by AbbVie, Inc.