Measure Up Data Support Long-Term Laboratory Safety With Upadacitinib in Atopic Dermatitis

Key Takeaways

• Investigators reported that most lipid, liver enzyme, and creatine phosphokinase laboratory values remained within normal limits through 140 weeks of upadacitinib treatment in moderate-to-severe atopic dermatitis.
• Serious creatine phosphokinase events were rare, occurring at rates below 0.1 events per 100 patient-years, while laboratory-related treatment discontinuations remained below 2% through week 140.
• Weight increase adverse events were infrequent across both upadacitinib dosing groups over approximately 3 years of follow-up.

Most laboratory parameters remained within normal limits through 140 weeks of upadacitinib treatment in adolescents and adults with moderate-to-severe atopic dermatitis (AD), according to findings presented at the 2026 Society for Investigative Dermatology Annual Meeting. Investigators also reported that laboratory changes were generally transient and normalized over time, while treatment discontinuations related to laboratory abnormalities remained uncommon at less than 2% through nearly 3 years of follow-up. 

The poster, "Long-Term Laboratory Trends in Patients With Moderate-to-Severe Atopic Dermatitis Treated With Upadacitinib: 140-Week Results From Measure Up 1 and 2," was presented by David G. Cotter, MD; Mona Shahriari, MD; Diego Ruiz Dasilva, MD; Erik Domingues, MD; Shanthi Narla, MD; Mark G. Kirchhof, MD, PhD; Rachel Goldberg; Meerat Oza; Deanne Dilley; Ayman Grada, MD; and Alan D. Irvine, MD. 

The analysis evaluated long-term laboratory and weight-change outcomes among participants enrolled in the phase 3 Measure Up 1 and Measure Up 2 trials. A total of 1213 patients were randomized to receive upadacitinib 15 mg or 30 mg daily, while 601 patients initially received placebo before rerandomization at week 16.

Baseline lipid, liver enzyme, and creatine phosphokinase (CPK) values were within normal limits across treatment groups, according to investigators. Mean lipid and liver enzyme values largely remained within normal ranges through week 140. CPK elevations were infrequent and generally mild or moderate in severity. Mean CPK levels peaked at week 4 in the upadacitinib 30-mg group at 414.5 U/L, with most elevations associated with exercise or physical exertion, before returning to within normal limits thereafter.

Grade 3 or higher laboratory abnormalities were limited, including alanine aminotransferase elevations in 0.6% to 1.3% of patients, aspartate aminotransferase elevations in 1.1% to 2.1%, and CPK elevations in 8.6% to 12.5%. Serious CPK events occurred at rates below 0.1 events per 100 patient-years.

Weight increase adverse events were uncommon during the first 16 weeks, occurring in 1.8% of patients receiving upadacitinib 15 mg and 1.9% receiving 30 mg, compared with 0.6% in the placebo group. Exposure-adjusted event rates for weight increase through week 140 were 1.27 and 1.79 events per 100 patient-years in the 15-mg and 30-mg groups, respectively.

“Over the course of 140 weeks of upadacitinib treatment, laboratory parameters largely remained within normal limits; changes in laboratory parameters were generally transient and normalized thereafter out to 3 years,” the authors wrote. “These findings support the long-term laboratory safety profile of upadacitinib in patients with moderate-to-severe atopic dermatitis.”