Published online: November 28, 2019
Atopic dermatitis is a chronic inflammatory skin disease associated with itchy skin lesions and impaired quality of life. Therapies to treat the condition are currently limited or associated with safety concerns. Upadacitinib, a Janus kinase 1 inhibitor, is approved for the treatment of rheumatoid arthritis and is currently being investigated for the treatment of several immune-mediated inflammatory diseases, including atopic dermatitis.
In a randomized-controlled trial recently published in The Journal of Allergy & Clinical Immunology (JACI), Guttman-Yassky and colleagues investigated the safety and efficacy of upadacitinib for the treatment of patients with moderate to severe atopic dermatitis that could not be controlled with topical treatments. The study enrolled 167 patients who were randomized to receive oral upadacitinib 7.5 mg, 15 mg, or 30 mg once-daily or placebo for 16 weeks in the initial stage of this 2-part clinical trial.
The study found that all doses of upadacitinib significantly improved the signs and symptoms of eczema compared with placebo at 16 weeks, with improvements observed within the first 1 to 2 weeks. The 30-mg once-daily dose showed the greatest clinical benefit in both skin and itch. Serious adverse events and serious infections were uncommon and occurred at a similar frequency with upadacitinib and placebo. Overall, the safety findings were comparable with previous upadacitinib studies.
This study by Guttman-Yassky et al showed that upadacitinib has a favorable benefit/risk profile in patients with atopic dermatitis that supports the further investigation of updacitinib in this patient population that has an unmet need for treatments with better efficacy and a safety profile compatible with long-term use.
The Journal of Allergy and Clinical Immunology (JACI) is an official scientific journal of the AAAAI, and is the most-cited journal in the field of allergy and clinical immunology.