Study: Upadacitinib Reduces Inflammation Markers in AD

Key Takeaways

• Upadacitinib (UPA) 15 mg and 30 mg significantly reduced Hs-CRP and AEC by week 2 in a cohort of patients with moderate-to-severe AD, with effects sustained to week 16.

• UPA 30 mg showed greater inflammation marker reductions than dupilumab in the Heads Up trial.

• Cardiovascular inflammation-related proteins (e.g., IL2RA, CEACAM8) were downregulated with UPA.

Upadacitinib (UPA) treatment was associated with significant reductions in biomarkers of systemic inflammation in adults with moderate-to-severe atopic dermatitis (AD), according to a poster presented at Winter Clinical 2026 in Hawaii.

The poster, Effect of Upadacitinib on Biomarkers of Systemic Inflammation in Patients with Moderate-to-Severe Atopic Dermatitis, by Christopher G. Bunick, Shawn G. Kwatra, Ayman Grada, Yingtao Bi, James Fann, Sara Murdock, Emma Guttman-Yassky, included data from the the Measure Up 1/2 and Heads Up phase 3 trials showing patients receiving once-daily oral UPA 15 mg or 30 mg experiencing significant reductions in high-sensitivity C-reactive protein (Hs-CRP) and absolute eosinophil count (AEC) vs. placebo. Improvements were observed as early as week 2 and were sustained through week 16.

In the Heads Up trial, UPA 30 mg demonstrated greater reductions in mean Hs-CRP and AEC than dupilumab (300 mg), with statistically significant differences at most visits, including week 16. At that time point, mean AEC levels declined to 0.20 ×10⁹/L in the UPA group compared to 0.44 ×10⁹/L in the dupilumab group.

A biomarker subgroup in the Heads Up study also indicated that UPA 30 mg treatment decreased several serum proteins associated with cardiovascular and immune activation. These included CEACAM8 (−32.5%), IL2RA (−49.9%), and XCL1 (−40.5%) at week 16. Serum proteins were measured using the Olink Cardiovascular II/III panel.

“Treatment with UPA in moderate-to-severe AD was associated with reductions in Hs-CRP, AEC and decreases across multiple proteins on the Olink cardiovascular panel,” the authors concluded. “Reductions in markers of systemic inflammation were rapid and sustained. Further research may be warranted to assess the long-term impact and clinical relevance of UPA/s effects on systemic inflammation."

Source: Bunick C, Kwatra S, Grada A, et al. Presented at: 2026 Winter Clinical Hawaii, January 16-21, Maui.