Jonathan Silverberg, MD, PhD, MPH

Treatment with upadacitinib led to substantial clinical improvements in both biologic-naïve and biologic-experienced adults with moderate-to-severe atopic dermatitis (AD) in real-world practice, according to 6-month data from the CorEvitas AD Registry presented at the 2025 Revolutionizing Atopic Dermatitis (RAD) Conference, held June 6-7 in Nashville, TN.

“Multiple phase 3 clinical trials have demonstrated the safety and efficacy of UPA for the treatment of AD; however, real-world outcomes, especially in patients with prior biologic exposure, are less understood,” investigators wrote.

The registry-based longitudinal analysis included 192 adults (mean age: bio-naïve, 45.8 years; bio-experienced, 47.7 years) receiving routine dermatologic care in the US and Canada. Patients had initiated upadacitinib (UPA) between January 2022 and April 2024 and remained on therapy through a 6-month follow-up.

Bio-naïve patients achieve high levels of disease control. Among 108 bio-naïve participants, 68.7% achieved validated Investigator Global Assessment for AD (vIGA-AD) scores of 0/1, and 64.1% achieved EASI 90 (≥90% improvement from baseline). EASI 100 was reached by 48.5%. Notably, 54.3% met criteria for minimal disease activity (MDA), defined as simultaneous achievement of EASI 90 and Peak Pruritus Numeric Rating Scale (PP-NRS) 0/1.

Additionally, 52.1% of bio-naïve patients reported no or minimal itch (PP-NRS 0/1), and 62.3% achieved Dermatology Life Quality Index (DLQI) scores of 0/1, reflecting no impact on quality of life.

Bio-experienced patients also benefit, though to a lesser degree. In the group of 84 bio-experienced participants—97.6% of whom had prior dupilumab exposure—upadacitinib was also associated with clinically meaningful outcomes. At 6 months, 52.6% achieved EASI 90, and 36.2% reached MDA. Complete clearance (EASI 100) was achieved by 40.8%.

While fewer bio-experienced participants achieved pruritus and quality-of-life targets, 34.7% reported PP-NRS 0/1 and 39.7% reached DLQI 0/1. Overall, 62.3% achieved vIGA-AD 0/1.

Most individuals in both groups initiated upadacitinib at 15 mg daily. Among bio-naïve participants, 75% of those with dose changes increased to 30 mg, while all bio-experienced adults with dose changes (n = 12) escalated to 30 mg. Mean treatment duration was approximately 6 months.

No formal hypothesis testing was performed, and results reflect only those who remained on UPA for the study duration. Safety data were not included in this interim analysis, but findings were consistent with prior clinical trial experience.

“Findings from this real-world study are consistent with clinical trial results and show the potential of UPA to offer multidimensional relief to people with AD in routine clinical practice,” researchers concluded.

Source: Silverberg JI, Gooderham M, Bunick CG, et al. Real-world effectiveness of upadacitinib in moderate-to-severe atopic dermatitis (AD) in bio-experienced and bio-naïve patients: Results from longitudinal analyses of the CorEvitas AD registry. Poster presented at: Revolutionizing Atopic Dermatitis 2025; June 6-7, 2025; Nashvhille, TN.

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