This paper compares two medications for treating moderate-to-severe atopic dermatitis: upadacitinib (an oral medication) and dupilumab (an injection). The study aimed to determine which medication works better and is safer.
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Efficacy and Safety of Upadacitinib vs Dupilumab in Adults With Moderate-to-Severe Atopic Dermatitis
Efficacy and Safety of Upadacitinib vs Dupilumab in Adults With Moderate-to-Severe Atopic Dermatitis
Andrew Blauvelt, Henrique D Teixeira, Eric L Simpson, Antonio Costanzo, Marjolein De Bruin-Weller, Sebastien Barbarot, Vimal H Prajapati, Peter Lio, Xiaofei Hu, Tianshuang Wu, John Liu, Barry Ladizinski, Alvina D Chu, Kilian Eyerich
DOI: 10.1001/jamadermatol.2021.3023
Controlled Clinical Trial
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673 participants
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2021
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119 citations
Key insights related to Rinvoq from this study:
- Upadacitinib shows superior efficacy compared to dupilumab (another common treatment) in improving skin clearance and reducing itch, with faster onset of action
- The medication has an acceptable safety profile, with the most common side effects being injection site reactions and conjunctivitis (eye inflammation). Serious side effects are rare. Dupilumab actually reduces skin infections compared to placebo.
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What is this paper about?
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How did the authors study this?
This was a 24-week clinical trial comparing upadacitinib and dupilumab. 673 patients were randomly assigned to receive either upadacitinib pills daily or dupilumab injections every two weeks. The researchers measured improvements in skin symptoms and itching, and tracked side effects.
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What populations did the authors study?
The study included adults aged 18-75 years with moderate-to-severe atopic dermatitis who hadn't responded well enough to topical treatments. The average age was 36 years, and about half were men. Patients had not previously used either of these medications.
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What did the authors find?
Upadacitinib worked better and faster than dupilumab. After 16 weeks, 72% of patients on upadacitinib had clear or almost clear skin compared to 63% on dupilumab. Upadacitinib also reduced itching more quickly. However, upadacitinib had more side effects, including acne, infections, and blood test abnormalities, while dupilumab had more eye-related side effects.
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What conclusions can we draw?
The researchers concluded that upadacitinib was more effective than dupilumab for treating moderate-to-severe atopic dermatitis, working faster and achieving better skin clearance. While both medications were generally safe, each had its own set of potential side effects that need to be considered when choosing treatment.
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