42065 Improvement in Itch, Symptoms, and Quality of Life With Upadacitinib Through Week 16 in Adults and Adolescents With Atopic Dermatitis: Results From Phase 3 Studies (Measure Up 1, Measure Up 2, and AD Up)

Background: Atopic dermatitis (AD) is characterized by intense itch and symptoms that adversely impact quality of life (QoL). Upadacitinib is a selective Janus kinase-1 inhibitor approved for moderate-to-severe AD. We assessed the effect of once daily oral upadacitinib (15 or 30 mg) on patient-reported outcomes for adults and adolescents during the double-blind, placebo-controlled periods of Measure Up 1 (NCT03569293), Measure Up 2 (NCT03607422), and AD Up (NCT03568318). Assessments included itch (Worst Pruritus Numerical Rating Scale); skin pain and symptom severity (AD Symptom Scale); symptom frequency (Patient Oriented Eczema Measure); and sleep, daily activities, and emotional state (AD Impact Scale). Post-hoc analysis of 2240 adults and 344 adolescents randomized patients was performed. By week 2, more patients receiving upadacitinib achieved a clinically relevant response in itch, skin pain, symptom severity, symptom frequency, sleep, daily activities, and emotional state vs placebo across studies among adults (upadacitinib 15 mg: 30.8-87.3%; upadacitinib 30 mg: 38.0-89.9%; placebo: 2.1- 43.1%; nominal P<.001 for all comparisons) and adolescents (upadacitinib 15 mg: 19.4-82.9%; upadacitinib 30 mg: 35.3-97.6%; placebo: 0-41.0%; nominal P<.05 for 37/42 comparisons). These trends continued through week 16 where response rates for all outcomes improved with upadacitinib vs placebo in adults (upadacitinib 15 mg: 42.9-80.4%; upadacitinib 30 mg: 60.9-84.6%; placebo: 10.1- 38.1%; nominal P<.001 for all comparisons) and adolescents (upadacitinib 15 mg: 33.3-78.0%; upadacitinib 30 mg: 50.0-85.7%; placebo: 2.8-43.6%; nominal P<.05 for 41/42 comparisons). These findings highlight the rapid, sustained efficacy of once daily oral upadacitinib in improving symptom burden and QoL in adults and adolescents with moderate-to-severe AD.