Effect of upadacitinib on atopic hand eczema in patients with moderate‐to‐severe atopic dermatitis: Results from two randomized phase 3 trials

E L Simpson, K Rahawi, X Hu, A D Chu, C Nduaka, S Jazayeri, P Lio, C Lynde, M L A Schuttelaar

DOI: 10.1111/jdv.19194

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• What is this paper about?

  This paper looks at how well the medication upadacitinib works for treating hand eczema in people who have moderate-to-severe atopic dermatitis. The study specifically focused on how the medication affected hand eczema over 16 weeks.

• How did the authors study this?

  The researchers conducted two large clinical trials called Measure Up 1 and 2. They divided patients into three groups - some received 15mg of upadacitinib daily, others received 30mg daily, and the third group received a placebo. They measured the severity of hand eczema using a scale called the Hand Eczema Severity Index (HECSI).

• What populations did the authors study?

  The study included patients aged 12-75 years who had moderate-to-severe atopic dermatitis with hand involvement. About 60% of atopic dermatitis patients have hand involvement, adding to their disease burden.

• What did the authors find?

  Both doses of upadacitinib (15mg and 30mg) showed significant improvement in hand eczema compared to placebo, with improvements seen as early as week 1. By week 16, patients taking upadacitinib had about 68-74% improvement in their hand eczema, while placebo patients either had minimal improvement or got worse. More patients taking upadacitinib achieved at least 75% improvement in their hand eczema compared to those taking placebo.

• What conclusions can we draw?

  The authors concluded that upadacitinib was effective at treating hand eczema in people with moderate-to-severe atopic dermatitis. The improvements were both rapid and long-lasting through the 16-week study period. They suggest that upadacitinib could be an effective treatment option for people with atopic hand eczema.