Atopic Dermatitis Treatment with Upadacitinib Mono and Combination Regimens

The oral Janus kinase (JAK) inhibitor, upadacitinib — alone or with topical corticosteroids (TCS) — is effective and tolerable in the treatment of patients with moderate-to-severe atopic dermatitis (AD). According to B. Calimlim and colleagues, the potential economic impact of upadacitinib via reducing AD-related work productivity and activity impairment is unexplored. In their study, presented at AMCP 2022, they found that treatment with upadacitinib “resulted in greater improvements in [work productivity loss (WPL)], presenteeism, and overall activity impairment compared with placebo, translating to annual indirect cost savings of approximately $5,500–$8,000.”

The study utilized data of patients with moderate-to-severe AD from the Measure Up 1 and AD Up phase III trials. The recruited patients were randomized 1:1:1 to receive once-daily upadacitinib 15 mg, upadacitinib 30 mg, or a placebo. The Work Productivity and Activity Impairment questionnaire was used to assess AD-related absenteeism, presenteeism, WPL, and activity impairment.

The study’s authors reported that the mean baseline impairment was similar between the 15 mg, 30 mg, and placebo groups in terms of absenteeism, presenteeism, WPL, and activity impairment. At week 16, both upadacitinib groups showed statistically significant improvements in presenteeism, WPL, and activity impairment, as well as numerically greater improvements in absenteeism. Centrally, the authors reported that “the WPL changes at week 16 translated to a decrease in annual indirect costs of $8,254–$9,932 with upadacitinib monotherapy versus $1,952 with placebo in Measure Up 1, and $11,199–$12,843 with upadacitinib plus TCS versus $5,651 with placebo plus TCS in AD Up.”

Based on their analysis, Calimlim and colleagues concluded that upadacitinib 15 mg or 30 mg, whether used as monotherapy or in combination with other TCS, appeared to have “the potential to impact indirect costs by improving work-related impairment” in patients with moderate-to-severe AD.