Rapid itch improvement with upadacitinib with or without concomitant topical corticosteroids in moderate-to-severe atopic dermatitis: results from three phase III studies (Measure Up 1, Measure Up 2 and AD Up)

Blauvelt, A., Ardern-Jones, M.R., Bieber, T., Hong, C., Chu, C. -Y., Liu, M., Yang, Y., Ladizinski, B., Teixeira, H.D., Calimlim, B.M. and Thyssen, J.P. (2021) Rapid itch improvement with upadacitinib with or without concomitant topical corticosteroids in moderate-to-severe atopic dermatitis: results from three phase III studies (Measure Up 1, Measure Up 2 and AD Up). British Journal of Dermatology, 185 (3), E117-E118. (doi:10.1111/bjd.20648).

Abstract

Upadacitinib is a novel Janus kinase 1-selective inhibitor under investigation for treatment in patients with atopic dermatitis (AD). We evaluated the magnitude and time of itch improvement and proportion of patients with clinically meaningful improvement in itch following treatment with upadacitinib. Measure Up 1 (NCT03569293), Measure Up 2 (NCT03607422) and AD Up (NCT03568318) are randomized, phase III, double-blinded, placebo-controlled, multicentre studies evaluating upadacitinib in adolescents and adults with moderate-to-severe AD. Patients were randomized 1 : 1 : 1 to receive oral upadacitinib 15 mg, 30 mg or placebo once daily alone (Measure Up 1 and 2), or with concomitant topical corticosteroids (TCS; AD Up). In Measure Up 1, Measure Up 2 and AD Up, respectively, significantly greater proportions of patients with Worst Pruritus Numerical Rating Scale (NRS) ≥ 4 at baseline who were treated with upadacitinib vs. placebo (P < 0·001) achieved Worst Pruritus NRS improvement ≥ 4 at weeks 1 (15 mg: 15·0%, 7·4% and 12·2%; 30 mg: 19·6%, 15·7% and 19·2%; placebo: 0·4%, 0·7% and 3·1%, respectively) and 16 (15 mg: 52·2%, 41·9% and 51·7%; 30 mg: 60·0%, 59·6% and 63·9%; placebo: 11·8%, 9·1% and 15·0%, respectively). In Measure Up 1, and Measure Up 2, respectively, significant differences (P < 0·001) were observed as early as days 2 (30 mg: 11·8% and 7·9%, respectively; placebo: 3·7% and 0·7%, respectively) and 3 (15 mg: 16·4% and 11·5%, respectively; placebo: 3·3% and 3·0%, respectively). In all three studies, these findings were supported by the mean percentage change in Worst Pruritus NRS at weeks 1 and 16. In summary, upadacitinib with or without concomitant TCS rapidly and significantly improved itch in patients with moderate-to-severe AD and Worst Pruritus NRS ≥ 4 at baseline.

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Contributors

Author: M.R. Ardern-Jones

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