Long-term upadacitinib use feasible for adolescents with atopic dermatitis

Long-term treatment of adolescents with moderate-to-severe atopic dermatitis (AD) with upadacitinib is safe and effective through 76 weeks, according to a study published online Oct. 23 in JAMA Dermatology.

Amy S. Paller, M.D., from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues evaluated the efficacy and adverse events of upadacitinib in adolescent patients with moderate-to-severe AD through 76 weeks. The analysis included data from 542 adolescents participating in the Measure Up 1, Measure Up 2, and AD Up clinical trials.

The researchers found that at week 76, ≥75 percent reduction in the Eczema Area and Severity Index Score (EASI-75) was achieved by 89.1, 84.4, and 87.8 percent of adolescents taking upadacitinib 15 mg in the Measure Up 1, Measure Up 2, and AD Up trials, respectively. For a dose of 30 mg, EASI-75 was achieved by 96.1, 93.6, and 82.7 percent of adolescents, respectively. Across both upadacitinib doses, results indicated maintenance or improvement of EASI-75 across 76 weeks. Long-term outcomes in trial participants were consistent with the known adverse event profile of upadacitinib (herpetic infection: 4.0, 1.9, and 1.1 events per 100 patient-years, respectively; creatine kinase elevation: 11.6, 11.0, and 7.1 events per 100 patient-years, respectively), with no new signals noted with either dose.

“While the difference in the proportions of patients achieving at least EASI-75 between the two upadacitinib treatment groups is small, the difference between the two doses becomes more pronounced over time in the more stringent efficacy end points, such as EASI-90,” the authors write.

Several authors disclosed ties to pharmaceutical companies, including AbbVie, which manufactures upadacitinib and funded the study.

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