Upadacitinib Shows Rapid, Durable Skin Pain Relief in Moderate-to-Severe Atopic Dermatitis

Poster data presented at Winter Clinical Hawaii indicated rapid and sustained reductions in skin pain among adults and adolescents with moderate-to-severe atopic dermatitis (AD) treated with upadacitinib. The analysis emphasized skin pain as a clinically meaningful symptom in AD and suggests that effective control may translate into broader improvements in patient-reported outcomes. 

Results from an integrated analysis of the phase 3 Measure Up 1 and Measure Up 2 trials were presented in the poster, titled “Rapid and Durable Skin Pain Relief with Upadacitinib in Adults and Adolescents with Moderate-to-Severe Atopic Dermatitis” and authored by Christopher G. Bunick, MD, PhD; Peter A. Lio, MD; Mona Shahriari, MD; Diego Ruiz Dasilva, MD; Ayman Grada, MD; Brian Calimlim, PhD; David Prefontaine, PhD; Chao Li, PhD; Jianzhong Zhang, MD; Vipul Jain, MD; Pedro Mendes-Bastos, MD, PhD; and Eric L. Simpson, MD, MCR.

The analysis included adults and adolescents with moderate-to-severe AD treated with once-daily upadacitinib 15-mg or 30-mg monotherapy. Skin pain was assessed using the Atopic Dermatitis Symptom Scale Skin Pain Numerical Rating Scale (SP-NRS; 0–10). An optimal outcome was defined as SP-NRS 0 or 1 (no or minimal pain), while a clinically meaningful improvement was defined as a ≥3-point reduction. 

At baseline, 85% of patients reported significant skin pain (SP-NRS ≥4). Compared with placebo, significantly higher proportions of patients receiving UPA achieved SP-NRS 0/1 as early as Day 2 after treatment initiation, with response rates continuing to increase through Week 4. By Week 16, 43.4% of patients receiving UPA 15 mg and 59.1% receiving UPA 30 mg achieved no or minimal skin pain. 

Importantly, responses were durable. Among observed cases, SP-NRS 0/1 response rates were maintained through Week 140, and patients who achieved optimal skin pain relief at Week 16 largely sustained benefit long term. Achieving minimal skin pain was also associated with better sleep, daily functioning, and emotional well-being. 

In their conclusion, the authors noted that rapid and durable skin pain relief with upadacitinib “supports skin pain as an important, treatment-responsive symptom and a meaningful therapeutic target in moderate-to-severe atopic dermatitis.”