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A Study to Evaluate Upadacitinib in Combination With Topical Corticosteroids in Adolescent and Adult Participants With Moderate to Severe Atopic Dermatitis

A Phase 3 Randomized, Placebo-Controlled, Double-Blind Study to Evaluate Upadacitinib in Combination With Topical Corticosteroids in Adolescent and Adult Subjects With Moderate to Severe Atopic Dermatitis

Status
Active, not recruiting
Phases
Phase 3
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT03568318
Acronym
AD Up
Enrollment
1533
Registered
2018-06-26
Start date
2018-08-09
Completion date
2030-10-23
Last updated
2025-12-23

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Atopic Dermatitis

Keywords

Atopic Dermatitis, Upadacitinib

Brief summary

The objective of this study is to assess the efficacy and safety of upadacitinib combined with topical corticosteroids (TCS) for the treatment of adolescent and adult participants with moderate to severe atopic dermatitis (AD) who are candidates for systemic therapy.

Detailed description

This study includes a 35-day screening period, a 16-week double-blind period, a blinded extension period up to Week 260, a blinded Long-term Extension (LTE) Period after Week 260 to Week 524, and a 30-day follow-up visit. Participants who meet eligibility criteria in the Main Study will be randomly assigned in a 1:1:1 ratio to receive upadacitinib 15 mg, upadacitinib 30 mg, or placebo once daily, in combination with topical corticosteroids. Upon completion of enrollment of 810 participants in the Main Study, a supplemental study will continue to enroll adolescent participants (Adolescent Sub-study) until a total of 180 adolescent participants are enrolled in the overall study (Main Study + Adolescent Sub-study). Approximately 1000 participants from M16-045 or M18-891 and approximately 500 participants from M16-047 will have the opportunity to enroll into the blinded Long-Term Extension (LTE) period (Week 260 - Week 524) after reaching Week 260 in their respective studies. Randomization for the Main Study will be stratified by Baseline disease severity (validated Investigator Global Assessment Scale for Atopic Dermatitis \[vIGA-AD\] score of moderate \[3\] versus severe \[4\]), by geographic region (US/Puerto Rico/Canada, Japan, China, and Other), and by age (adolescent \[ages 12 to 17\] versus adult \[ages 18 to 75\]). The separate randomization for the Adolescent Sub-study will be stratified by Baseline disease severity (moderate \[vIGA-AD 3\] versus severe \[vIGA-AD 4\]) and by geographic region (US/Puerto Rico/Canada and Other). At Week 16 of both the Main Study and the Adolescent Sub-study, participants in the placebo group will be re-randomized in a 1:1 ratio to receive daily oral doses of upadacitinib 30 mg or upadacitinib 15 mg in the blinded extension period, and participants originally randomized to upadacitinib will continue upadacitinib in the extension period at the same dose. For the Main Study, the re-randomization will be stratified by Eczema Area and Severity Index (EASI) 50 responder status (Yes/No), by geographic region (US/Puerto Rico/Canada, Japan, China, and Other) and by age (adolescent \[ages 12 to 17\] versus adult \[ages 18 to 75\]). For the Adolescent Sub-study, the re-randomization will be stratified by EASI 50 responder (Yes/No) and by geographic region (US/Puerto Rico/Canada and Other). Starting at Week 4, rescue treatment for AD may be provided at the discretion of the investigator if medically necessary The Primary Analysis for the Main Study will be conducted after all ongoing participants have completed Week 16. In addition, a Primary Analysis for the adolescent population (including the adolescent participants from the Main Study and the Adolescent Sub-study) will be conducted after all ongoing adolescent participants have completed Week 16.

Interventions

DRUGPlacebo

Tablets taken orally once a day

DRUGUpadacitinib

Tablets taken orally once a day

Topical corticosteroids will be applied in a stepdown regimen, starting with medium potency once daily to areas with active lesions until lesions are clear or almost clear, or for 3 consecutive weeks, whichever is shorter; then low potency topical corticosteroids once daily. If lesions return or persist, this step-down approach will be repeated until lesion resolution or evidence of local or systemic topical corticosteroids toxicity. Recommended TCS include triamcinolone acetonide 0.1% cream or fluocinolone acetonide 0.025% ointment as medium potency topical corticosteroids and hydrocortisone 1% cream as low potency topical corticosteroid.

Sponsors

AbbVie
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Eligibility

Sex/Gender
ALL
Age
12 Years to 75 Years
Healthy volunteers
No

Inclusion criteria

* Body weight of ≥ 40 kg at Baseline Visit for participants ≥ 12 and \< 18 years of age * Chronic atopic dermatitis (AD) with onset of symptoms at least 3 years prior to Baseline Visit and subject meets Hanifin and Rajka criteria. * Active moderate to severe atopic dermatitis defined by Eczema Area and Severity Index (EASI) ≥ 16, validated Investigator's Global Assessment (vIGA) ≥ 3, ≥ 10% of body surface area (BSA) with AD involvement, and weekly average of daily Worst Pruritus numerical rating scale (NRS) ≥ 4. * Subject has applied a topical emollient (moisturizer) twice daily for at least 7 days before the Baseline Visit. * Documented history of inadequate response to topical corticosteroids or topical calcineurin inhibitor OR documented systemic treatment for AD within 6 months prior to Baseline Visit

Exclusion criteria

* Prior exposure to any Janus kinase (JAK) inhibitor * Unable or unwilling to discontinue current atopic dermatitis (AD) treatments prior to the study * Requirement of prohibited medications during the study * Other active skin diseases or skin infections requiring systemic treatment or would interfere with appropriate assessment of atopic dermatitis lesions * Female subject who is pregnant, breastfeeding, or considering pregnancy during the study

Design outcomes

Primary

MeasureTime frameDescription
Main Study: Percentage of Participants Achieving at Least a 75% Reduction in Eczema Area and Severity Index Score (EASI 75) From Baseline at Week 16Baseline and Week 16EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease.
Main Study: Percentage of Participants Achieving Validated Investigator Global Assessment for Atopic Dermatitis (vIGA-AD) of 0 or 1 With a Reduction From Baseline of ≥ 2 Points at Week 16Baseline and Week 16The vIGA-AD is a validated assessment instrument to rate the severity of atopic dermatitis globally, based on the following scale: * 0 - Clear: No inflammatory signs of AD; * 1 - Almost clear: Barely perceptible erythema, induration/papulation and/or lichenification; * 2 - Mild: Slight but definite erythema, induration/papulation and/or minimal lichenification. No oozing or crusting; * 3 - Moderate: Clearly perceptible erythema, induration/papulation and/or lichenification, oozing or crusting may be present; * 4 - Severe: Marked erythema, induration/papulation and/or lichenification; Oozing or crusting may be present.

Secondary

MeasureTime frameDescription
Main Study: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 4Baseline (last available rolling average before the first dose of study drug) and Week 4Participants were asked to rate itch (pruritus) intensity at its worst during the past 24 hours on a daily basis using an 11-point scale from 0 (no itch) to 10 (worst imaginable itch). Pruritus NRS was analyzed based on weekly rolling averages of daily scores.
Main Study: Percentage of Participants Achieving an EASI 75 Response at Week 4Baseline and Week 4EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease. An EASI 75 response is defined as at least a 75% reduction (improvement) from Baseline in EASI score.
Main Study: Percentage of Participants Achieving an EASI 75 Response at Week 2Baseline and Week 2EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease. An EASI 75 response is defined as at least a 75% reduction (improvement) from Baseline in EASI score.
Main Study: Percentage of Participants Achieving an EASI 90 Response at Week 4Baseline and Week 4EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/ neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease.
Main Study: Percentage of Participants Achieving a 100% Reduction From Baseline in EASI Score (EASI 100) at Week 16Baseline and Week 16EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored from 0 \[none\], to 3 \[severe\]) for redness, thickness, scratching, and lichenification. The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease. The percentage of participants with an EASI 100 response at Week 16 was pre-specified as a ranked secondary endpoint for participants in the Upadacitinib 30 mg + Topical Corticosteroids group versus Placebo + Topical Corticosteroids group only.
Main Study: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 1Baseline (last available rolling average before the first dose of study drug) and Week 1Participants were asked to rate itch (pruritus) intensity at its worst during the past 24 hours on a daily basis using an 11-point scale from 0 (no itch) to 10 (worst imaginable itch). Pruritus NRS was analyzed based on weekly rolling averages of daily scores.
Main Study: Percent Change From Baseline in Worst Pruritus NRS at Week 16Baseline (last available rolling average before the first dose of study drug) and Week 16Participants were asked to rate itch (pruritus) intensity at its worst during the past 24 hours on a daily basis using an 11-point scale from 0 (no itch) to 10 (worst imaginable itch). Pruritus NRS was analyzed based on weekly rolling averages of daily scores. A negative change from Baseline indicates improvement.
Main Study: Percent Change From Baseline in EASI Score at Week 16Baseline and Week 16EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1)\] moderate \[2\], or severe \[3\]) for Redness (erythema, inflammation), Thickness (induration, papulation, swelling - acute eczema), Scratching (excoriation), and Lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease; a negative change from Baseline indicates improvement.
Adolescents: Percentage of Participants Achieving an EASI 75 Response at Week 16Baseline and Week 16EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease. An EASI 75 response is defined as at least a 75% reduction (improvement) from Baseline in EASI score.
Adolescents: Percentage of Participants Achieving a vIGA-AD of 0 or 1 With a Reduction From Baseline of ≥ 2 Points at Week 16Baseline and Week 16The vIGA-AD is a validated assessment instrument to rate the severity of atopic dermatitis globally, based on the following scale: * 0 - Clear: No signs of AD; * 1 - Almost clear: Barely perceptible erythema, induration/papulation and/or lichenification; * 2 - Mild: Slight but definite erythema, induration/papulation and/or minimal lichenification. No oozing or crusting; * 3 - Moderate: Clearly perceptible erythema, induration/papulation and/or lichenification, possible oozing or crusting; * 4 - Severe: Marked erythema, induration/papulation and/or lichenification; possible oozing or crusting.
Main Study: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus Numerical Rating Scale (NRS) at Week 16Baseline (last available rolling average before the first dose of study drug) and Week 16Participants were asked to rate itch (pruritus) intensity at its worst during the past 24 hours on a daily basis using an 11-point scale from 0 (no itch) to 10 (worst imaginable itch). Pruritus NRS was analyzed based on weekly rolling averages of daily scores.
Adolescents: Percentage of Participants Achieving an EASI 90 Response at Week 16Baseline and Week 16EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease. An EASI 90 response is defined as at least a 90% reduction (improvement) from Baseline in EASI score.
Adolescents: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 4Baseline (last available rolling average before the first dose of study drug) and Week 4Participants were asked to rate itch (pruritus) intensity at its worst during the past 24 hours on a daily basis using an 11-point scale from 0 (no itch) to 10 (worst imaginable itch). Worst pruritus NRS was analyzed based on weekly rolling averages of daily scores.
Adolescents: Percentage of Participants Achieving an EASI 75 Response at Week 4Baseline and Week 4EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease. An EASI 75 response is defined as at least a 75% reduction (improvement) from Baseline in EASI score.
Adolescents: Percentage of Participants Achieving an EASI 75 Response at Week 2Baseline and Week 2EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease. An EASI 75 response is defined as at least a 75% reduction (improvement) from Baseline in EASI score.
Adolescents: Percentage of Participants Achieving an EASI 90 Response at Week 4Baseline and Week 4EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease. An EASI 90 response is defined as at least a 90% reduction (improvement) from Baseline in EASI score.
Adolescents: Percentage of Participants Achieving an EASI 100 Response at Week 16Baseline and Week 16EASI is used to measure the extent and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. and the severity score is calculated as the sum of the intensity scores (scored from 0 \[none\], to 3 \[severe\]) for redness, thickness, scratching, and lichenification. The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease. An EASI 100 response is defined as a 100% reduction (improvement) from Baseline in EASI score. The percentage of participants with an EASI 100 response at Week 16 was pre-specified as a secondary endpoint for participants in the Upadacitinib 30 mg + TCS group versus Placebo + TCS group only.
Adolescents: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 1Baseline (last available rolling average before the first dose of study drug) and Week 1Participants were asked to rate itch (pruritus) intensity at its worst during the past 24 hours on a daily basis using an 11-point scale from 0 (no itch) to 10 (worst imaginable itch). Worst pruritus NRS was analyzed based on weekly rolling averages of daily scores.
Adolescents: Percent Change From Baseline in Worst Pruritus NRS at Week 16Baseline (last available rolling average before the first dose of study drug) and Week 16Participants were asked to rate itch (pruritus) intensity at its worst during the past 24 hours on a daily basis using an 11-point scale from 0 (no itch) to 10 (worst imaginable itch). Pruritus NRS was analyzed based on weekly rolling averages of daily scores. A negative change from Baseline indicates improvement.
Adolescents: Percent Change From Baseline in EASI Score at Week 16Baseline and Week 16EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1)\] moderate \[2\], or severe \[3\]) for Redness (erythema, inflammation), Thickness (induration, papulation, swelling - acute eczema), Scratching (excoriation), and Lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease; a negative change from Baseline indicates improvement.
Adolescents: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 16Baseline (last available rolling average before the first dose of study drug) and Week 16Participants were asked to rate itch (pruritus) intensity at its worst during the past 24 hours on a daily basis using an 11-point scale from 0 (no itch) to 10 (worst imaginable itch). Worst pruritus NRS was analyzed based on weekly rolling averages of daily scores.
Main Study: Percentage of Participants Achieving a 90% Reduction From Baseline in EASI Score (EASI 90) at Week 16Baseline and Week 16EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/ neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease.

Countries

Australia, Austria, Belgium, Canada, China, Czechia, France, Germany, Greece, Hong Kong, Hungary, Ireland, Israel, Italy, Japan, Netherlands, New Zealand, Norway, Puerto Rico, Slovakia, Spain, Sweden, United Kingdom, United States

Participant flow

Recruitment details

Participants were enrolled at 171 clinical sites in 22 countries in the Asia-Pacific region, Europe, Middle East, North America, and Oceania. The study included a 16-week double-blind treatment period followed by a blinded extension period (ongoing). The first 810 adults and adolescents enrolled constituted the Main Study; additional adolescents were enrolled in the Adolescent Substudy to ensure enrollment of a total of 180 adolescent participants overall. Results are reported up to Week 16.

Pre-assignment details

Participants were randomized equally into 1 of 3 treatment groups, stratified by disease severity (validated Investigator Global Assessment Scale for Atopic Dermatitis \[vIGA-AD\] moderate \[3\] vs severe \[4\]), geographic region (US/Puerto Rico/Canada, Japan, China, and Other), and age (adolescent \[ages 12 to 17\] vs adult \[ages 18 to 75\]). Randomization for the adolescent substudy was stratified by disease severity (vIGA-AD 3 vs vIGA-AD 4) and geographic region (US/Puerto Rico/Canada vs Other).

Participants by arm

ArmCount
Adults: Placebo + Topical Corticosteroids
Participants ≥ 18 years old received placebo orally once a day (QD) and topical corticosteroids following a step-down regimen for 16 weeks in the double-blind treatment period.
264
Adults: Upadacitinib 15 mg + Topical Corticosteroids
Participants ≥ 18 years old received upadacitinib 15 mg orally once a day and topical corticosteroids following a step-down regimen for 16 weeks in the double-blind treatment period.
261
Adults: Upadacitinib 30 mg + Topical Corticosteroids
Participants ≥ 18 years old received upadacitinib 30 mg orally once a day and topical corticosteroids following a step-down regimen for 16 weeks in the double-blind treatment period.
260
Adolescents: Placebo + Topical Corticosteroids
Adolescent participants (12 - 17 years old) received placebo orally once a day and topical corticosteroids following a step-down regimen for 16 weeks in the double-blind treatment period.
63
Adolescents: Upadacitinib 15 mg + Topical Corticosteroids
Adolescent participants received upadacitinib 15 mg orally once a day and topical corticosteroids following a step-down regimen for 16 weeks in the double-blind treatment period.
60
Adolescents: Upadacitinib 30 mg + Topical Corticosteroids
Adolescent participants received upadacitinib 30 mg orally once a day and topical corticosteroids following a step-down regimen for 16 weeks in the double-blind treatment period.
60
Total968

Withdrawals & dropouts

PeriodReasonFG000FG001FG002FG003FG004FG005
Overall StudyAdverse Event311010
Overall StudyLost to Follow-up322210
Overall StudyOngoing at Time of Analysis532100
Overall StudyOther313000
Overall StudyWithdrawal by Subject652100

Baseline characteristics

CharacteristicAdults: Placebo + Topical CorticosteroidsAdults: Upadacitinib 15 mg + Topical CorticosteroidsAdults: Upadacitinib 30 mg + Topical CorticosteroidsAdolescents: Placebo + Topical CorticosteroidsAdolescents: Upadacitinib 15 mg + Topical CorticosteroidsAdolescents: Upadacitinib 30 mg + Topical CorticosteroidsTotal
Age, Continuous37.2 years
STANDARD_DEVIATION 14.08
35.0 years
STANDARD_DEVIATION 13.29
38.3 years
STANDARD_DEVIATION 14.82
15.1 years
STANDARD_DEVIATION 1.85
15.4 years
STANDARD_DEVIATION 1.65
15.3 years
STANDARD_DEVIATION 1.86
32.8 years
STANDARD_DEVIATION 15.29
Age, Customized
12 - 14 years
0 Participants0 Participants0 Participants23 Participants14 Participants21 Participants58 Participants
Age, Customized
15 - 17 years
0 Participants0 Participants0 Participants40 Participants46 Participants39 Participants125 Participants
Age, Customized
18 - < 40 years
156 Participants176 Participants158 Participants0 Participants0 Participants0 Participants490 Participants
Age, Customized
40 - < 65 years
94 Participants80 Participants85 Participants0 Participants0 Participants0 Participants259 Participants
Age, Customized
≥ 65 years
14 Participants5 Participants17 Participants0 Participants0 Participants0 Participants36 Participants
Disease Duration since Diagnosis25.986 years
STANDARD_DEVIATION 15.565
24.511 years
STANDARD_DEVIATION 14.0363
24.617 years
STANDARD_DEVIATION 16.6107
12.315 years
STANDARD_DEVIATION 4.2769
11.370 years
STANDARD_DEVIATION 5.0674
12.244 years
STANDARD_DEVIATION 3.9262
22.584 years
STANDARD_DEVIATION 14.9374
Eczema Area and Severity Index (EASI) Score30.06 score on a scale
STANDARD_DEVIATION 12.86
29.03 score on a scale
STANDARD_DEVIATION 11.925
29.68 score on a scale
STANDARD_DEVIATION 11.993
30.25 score on a scale
STANDARD_DEVIATION 12.105
29.59 score on a scale
STANDARD_DEVIATION 11.683
28.68 score on a scale
STANDARD_DEVIATION 10.143
29.58 score on a scale
STANDARD_DEVIATION 12.082
Ethnicity (NIH/OMB)
Hispanic or Latino
15 Participants21 Participants14 Participants7 Participants8 Participants7 Participants72 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
249 Participants240 Participants246 Participants56 Participants52 Participants53 Participants896 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Geographic Region
China
16 Participants15 Participants15 Participants2 Participants2 Participants1 Participants51 Participants
Geographic Region
Japan
18 Participants16 Participants17 Participants0 Participants0 Participants0 Participants51 Participants
Geographic Region
Other
140 Participants140 Participants139 Participants30 Participants27 Participants28 Participants504 Participants
Geographic Region
US/Puerto Rico/Canada
90 Participants90 Participants89 Participants31 Participants31 Participants31 Participants362 Participants
Race (NIH/OMB)
American Indian or Alaska Native
1 Participants2 Participants3 Participants0 Participants0 Participants0 Participants6 Participants
Race (NIH/OMB)
Asian
52 Participants57 Participants58 Participants14 Participants13 Participants6 Participants200 Participants
Race (NIH/OMB)
Black or African American
15 Participants15 Participants9 Participants5 Participants5 Participants6 Participants55 Participants
Race (NIH/OMB)
More than one race
0 Participants7 Participants1 Participants0 Participants1 Participants2 Participants11 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants3 Participants1 Participants0 Participants0 Participants0 Participants4 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
White
196 Participants177 Participants188 Participants44 Participants41 Participants46 Participants692 Participants
Sex: Female, Male
Female
101 Participants104 Participants95 Participants36 Participants27 Participants25 Participants388 Participants
Sex: Female, Male
Male
163 Participants157 Participants165 Participants27 Participants33 Participants35 Participants580 Participants
Study Enrollment
Adolescent Substudy
0 Participants0 Participants0 Participants23 Participants21 Participants23 Participants67 Participants
Study Enrollment
Main Study
264 Participants261 Participants260 Participants40 Participants39 Participants37 Participants901 Participants
Validated Investigator Global Assessment Scale for Atopic Dermatitis (vIGA-AD)
3 (Moderate)
123 Participants124 Participants123 Participants28 Participants29 Participants29 Participants456 Participants
Validated Investigator Global Assessment Scale for Atopic Dermatitis (vIGA-AD)
4 (Severe)
141 Participants137 Participants137 Participants35 Participants31 Participants31 Participants512 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
EG003
affected / at risk
EG004
affected / at risk
EG005
affected / at risk
deaths
Total, all-cause mortality
0 / 2640 / 2610 / 2600 / 620 / 600 / 60
other
Total, other adverse events
99 / 264111 / 261123 / 26021 / 6224 / 6032 / 60
serious
Total, serious adverse events
9 / 2647 / 2614 / 2600 / 621 / 600 / 60

Outcome results

Primary

Main Study: Percentage of Participants Achieving at Least a 75% Reduction in Eczema Area and Severity Index Score (EASI 75) From Baseline at Week 16

EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease.

Time frame: Baseline and Week 16

Population: The intent-to-treat population for the main study (ITT\_M) includes all participants who were randomized in the main study (adults and adolescents). Non-responder imputation incorporating multiple imputation to handle missing data due to coronavirus disease 2019 pandemic (COVID-19) (NRI-C) was used.~The pre-specified primary analysis included participants enrolled in the main study only; Efficacy analyses of adolescent participants were conducted separately and are reported below.

ArmMeasureValue (NUMBER)
Placebo + Topical CorticosteroidsMain Study: Percentage of Participants Achieving at Least a 75% Reduction in Eczema Area and Severity Index Score (EASI 75) From Baseline at Week 1626.4 percentage of participants
Upadacitinib 15 mg + Topical CorticosteroidsMain Study: Percentage of Participants Achieving at Least a 75% Reduction in Eczema Area and Severity Index Score (EASI 75) From Baseline at Week 1664.6 percentage of participants
Upadacitinib 30 mg + Topical CorticosteroidsMain Study: Percentage of Participants Achieving at Least a 75% Reduction in Eczema Area and Severity Index Score (EASI 75) From Baseline at Week 1677.1 percentage of participants
p-value: <0.00195% CI: [43.8, 57.4]Cochran-Mantel-Haenszel
p-value: <0.00195% CI: [30.8, 45.4]Cochran-Mantel-Haenszel
Primary

Main Study: Percentage of Participants Achieving Validated Investigator Global Assessment for Atopic Dermatitis (vIGA-AD) of 0 or 1 With a Reduction From Baseline of ≥ 2 Points at Week 16

The vIGA-AD is a validated assessment instrument to rate the severity of atopic dermatitis globally, based on the following scale: * 0 - Clear: No inflammatory signs of AD; * 1 - Almost clear: Barely perceptible erythema, induration/papulation and/or lichenification; * 2 - Mild: Slight but definite erythema, induration/papulation and/or minimal lichenification. No oozing or crusting; * 3 - Moderate: Clearly perceptible erythema, induration/papulation and/or lichenification, oozing or crusting may be present; * 4 - Severe: Marked erythema, induration/papulation and/or lichenification; Oozing or crusting may be present.

Time frame: Baseline and Week 16

Population: Intent-to-treat population for the main study; Non-responder imputation incorporating multiple imputation to handle missing data due to COVID-19 (NRI-C) was used.

ArmMeasureValue (NUMBER)
Placebo + Topical CorticosteroidsMain Study: Percentage of Participants Achieving Validated Investigator Global Assessment for Atopic Dermatitis (vIGA-AD) of 0 or 1 With a Reduction From Baseline of ≥ 2 Points at Week 1610.9 percentage of participants
Upadacitinib 15 mg + Topical CorticosteroidsMain Study: Percentage of Participants Achieving Validated Investigator Global Assessment for Atopic Dermatitis (vIGA-AD) of 0 or 1 With a Reduction From Baseline of ≥ 2 Points at Week 1639.6 percentage of participants
Upadacitinib 30 mg + Topical CorticosteroidsMain Study: Percentage of Participants Achieving Validated Investigator Global Assessment for Atopic Dermatitis (vIGA-AD) of 0 or 1 With a Reduction From Baseline of ≥ 2 Points at Week 1658.6 percentage of participants
p-value: <0.00195% CI: [41.1, 54]Cochran-Mantel-Haenszel
p-value: <0.00195% CI: [22.1, 34.9]Cochran-Mantel-Haenszel
Secondary

Adolescents: Percentage of Participants Achieving an EASI 100 Response at Week 16

EASI is used to measure the extent and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. and the severity score is calculated as the sum of the intensity scores (scored from 0 \[none\], to 3 \[severe\]) for redness, thickness, scratching, and lichenification. The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease. An EASI 100 response is defined as a 100% reduction (improvement) from Baseline in EASI score. The percentage of participants with an EASI 100 response at Week 16 was pre-specified as a secondary endpoint for participants in the Upadacitinib 30 mg + TCS group versus Placebo + TCS group only.

Time frame: Baseline and Week 16

Population: Intent-to-treat population for adolescents; Non-responder imputation incorporating multiple imputation to handle missing data due to COVID-19 (NRI-C) was used.

ArmMeasureValue (NUMBER)
Placebo + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving an EASI 100 Response at Week 164.8 percentage of participants
Upadacitinib 15 mg + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving an EASI 100 Response at Week 1613.3 percentage of participants
Upadacitinib 30 mg + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving an EASI 100 Response at Week 1625.0 percentage of participants
p-value: 0.00195% CI: [7.8, 31.8]Cochran-Mantel-Haenszel
Secondary

Adolescents: Percentage of Participants Achieving an EASI 75 Response at Week 16

EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease. An EASI 75 response is defined as at least a 75% reduction (improvement) from Baseline in EASI score.

Time frame: Baseline and Week 16

Population: The ITT population for adolescents (ITT\_A) consists of all adolescent participants who were randomized in the main study or the adolescent sub-study. Non-responder imputation incorporating multiple imputation to handle missing data due to COVID-19 (NRI-C) was used.

ArmMeasureValue (NUMBER)
Placebo + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving an EASI 75 Response at Week 1630.3 percentage of participants
Upadacitinib 15 mg + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving an EASI 75 Response at Week 1663.3 percentage of participants
Upadacitinib 30 mg + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving an EASI 75 Response at Week 1684.3 percentage of participants
p-value: <0.00195% CI: [38.8, 67.4]Cochran-Mantel-Haenszel
p-value: <0.00195% CI: [16.3, 49]Cochran-Mantel-Haenszel
Secondary

Adolescents: Percentage of Participants Achieving an EASI 75 Response at Week 2

EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease. An EASI 75 response is defined as at least a 75% reduction (improvement) from Baseline in EASI score.

Time frame: Baseline and Week 2

Population: Intent-to-treat population for adolescents; Non-responder imputation incorporating multiple imputation to handle missing data due to COVID-19 (NRI-C) was used.

ArmMeasureValue (NUMBER)
Placebo + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving an EASI 75 Response at Week 29.5 percentage of participants
Upadacitinib 15 mg + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving an EASI 75 Response at Week 233.7 percentage of participants
Upadacitinib 30 mg + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving an EASI 75 Response at Week 251.7 percentage of participants
p-value: <0.00195% CI: [27.8, 55.1]Cochran-Mantel-Haenszel
p-value: 0.00195% CI: [10.3, 38.4]Cochran-Mantel-Haenszel
Secondary

Adolescents: Percentage of Participants Achieving an EASI 75 Response at Week 4

EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease. An EASI 75 response is defined as at least a 75% reduction (improvement) from Baseline in EASI score.

Time frame: Baseline and Week 4

Population: Intent-to-treat population for adolescents; Non-responder imputation incorporating multiple imputation to handle missing data due to COVID-19 (NRI-C) was used.

ArmMeasureValue (NUMBER)
Placebo + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving an EASI 75 Response at Week 428.6 percentage of participants
Upadacitinib 15 mg + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving an EASI 75 Response at Week 454.9 percentage of participants
Upadacitinib 30 mg + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving an EASI 75 Response at Week 478.3 percentage of participants
p-value: <0.00195% CI: [34.1, 64.6]Cochran-Mantel-Haenszel
p-value: 0.00295% CI: [9.4, 43.1]Cochran-Mantel-Haenszel
Secondary

Adolescents: Percentage of Participants Achieving an EASI 90 Response at Week 16

EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease. An EASI 90 response is defined as at least a 90% reduction (improvement) from Baseline in EASI score.

Time frame: Baseline and Week 16

Population: Intent-to-treat population for adolescents; Non-responder imputation incorporating multiple imputation to handle missing data due to COVID-19 (NRI-C) was used.

ArmMeasureValue (NUMBER)
Placebo + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving an EASI 90 Response at Week 1620.7 percentage of participants
Upadacitinib 15 mg + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving an EASI 90 Response at Week 1648.3 percentage of participants
Upadacitinib 30 mg + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving an EASI 90 Response at Week 1673.6 percentage of participants
p-value: <0.00195% CI: [37.3, 66.7]Cochran-Mantel-Haenszel
p-value: 0.00195% CI: [11.1, 43.1]Cochran-Mantel-Haenszel
Secondary

Adolescents: Percentage of Participants Achieving an EASI 90 Response at Week 4

EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease. An EASI 90 response is defined as at least a 90% reduction (improvement) from Baseline in EASI score.

Time frame: Baseline and Week 4

Population: Intent-to-treat population for adolescents; Non-responder imputation incorporating multiple imputation to handle missing data due to COVID-19 (NRI-C) was used.

ArmMeasureValue (NUMBER)
Placebo + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving an EASI 90 Response at Week 49.5 percentage of participants
Upadacitinib 15 mg + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving an EASI 90 Response at Week 434.2 percentage of participants
Upadacitinib 30 mg + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving an EASI 90 Response at Week 445.0 percentage of participants
p-value: <0.00195% CI: [20.6, 49.3]Cochran-Mantel-Haenszel
p-value: 0.00195% CI: [10.4, 38.7]Cochran-Mantel-Haenszel
Secondary

Adolescents: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 1

Participants were asked to rate itch (pruritus) intensity at its worst during the past 24 hours on a daily basis using an 11-point scale from 0 (no itch) to 10 (worst imaginable itch). Worst pruritus NRS was analyzed based on weekly rolling averages of daily scores.

Time frame: Baseline (last available rolling average before the first dose of study drug) and Week 1

Population: Intent-to-treat population for adolescents with Worst Pruritus NRS (weekly average) ≥ 4 at Baseline; Non-responder imputation incorporating multiple imputation to handle missing data due to COVID-19 (NRI-C) was used.

ArmMeasureValue (NUMBER)
Placebo + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 19.8 percentage of participants
Upadacitinib 15 mg + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 18.8 percentage of participants
Upadacitinib 30 mg + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 116.1 percentage of participants
p-value: 0.30695% CI: [-5.7, 18.2]Cochran-Mantel-Haenszel
p-value: 0.85595% CI: [-11.2, 9.3]Cochran-Mantel-Haenszel
Secondary

Adolescents: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 16

Participants were asked to rate itch (pruritus) intensity at its worst during the past 24 hours on a daily basis using an 11-point scale from 0 (no itch) to 10 (worst imaginable itch). Worst pruritus NRS was analyzed based on weekly rolling averages of daily scores.

Time frame: Baseline (last available rolling average before the first dose of study drug) and Week 16

Population: Intent-to-treat population for adolescents with Worst Pruritus NRS (weekly average) ≥ 4 at Baseline; Non-responder imputation incorporating multiple imputation to handle missing data due to COVID-19 (NRI-C) was used.

ArmMeasureValue (NUMBER)
Placebo + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 1621.3 percentage of participants
Upadacitinib 15 mg + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 1645.6 percentage of participants
Upadacitinib 30 mg + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 1651.8 percentage of participants
p-value: <0.00195% CI: [14.1, 46.8]Cochran-Mantel-Haenszel
p-value: 0.00395% CI: [8.2, 40.8]Cochran-Mantel-Haenszel
Secondary

Adolescents: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 4

Participants were asked to rate itch (pruritus) intensity at its worst during the past 24 hours on a daily basis using an 11-point scale from 0 (no itch) to 10 (worst imaginable itch). Worst pruritus NRS was analyzed based on weekly rolling averages of daily scores.

Time frame: Baseline (last available rolling average before the first dose of study drug) and Week 4

Population: Intent-to-treat population for adolescents with Worst Pruritus NRS (weekly average) ≥ 4 at Baseline; Non-responder imputation incorporating multiple imputation to handle missing data due to COVID-19 (NRI-C) was used.

ArmMeasureValue (NUMBER)
Placebo + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 423.0 percentage of participants
Upadacitinib 15 mg + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 445.6 percentage of participants
Upadacitinib 30 mg + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 446.4 percentage of participants
p-value: 0.00695% CI: [6.9, 40.1]Cochran-Mantel-Haenszel
p-value: 0.00795% CI: [6.2, 39.2]Cochran-Mantel-Haenszel
Secondary

Adolescents: Percentage of Participants Achieving a vIGA-AD of 0 or 1 With a Reduction From Baseline of ≥ 2 Points at Week 16

The vIGA-AD is a validated assessment instrument to rate the severity of atopic dermatitis globally, based on the following scale: * 0 - Clear: No signs of AD; * 1 - Almost clear: Barely perceptible erythema, induration/papulation and/or lichenification; * 2 - Mild: Slight but definite erythema, induration/papulation and/or minimal lichenification. No oozing or crusting; * 3 - Moderate: Clearly perceptible erythema, induration/papulation and/or lichenification, possible oozing or crusting; * 4 - Severe: Marked erythema, induration/papulation and/or lichenification; possible oozing or crusting.

Time frame: Baseline and Week 16

Population: The ITT population for adolescents (ITT\_A) consists of all adolescent participants who were randomized in the main study or the adolescent sub-study. Non-responder imputation incorporating multiple imputation to handle missing data due to COVID-19 (NRI-C) was used.

ArmMeasureValue (NUMBER)
Placebo + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving a vIGA-AD of 0 or 1 With a Reduction From Baseline of ≥ 2 Points at Week 1611.2 percentage of participants
Upadacitinib 15 mg + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving a vIGA-AD of 0 or 1 With a Reduction From Baseline of ≥ 2 Points at Week 1638.3 percentage of participants
Upadacitinib 30 mg + Topical CorticosteroidsAdolescents: Percentage of Participants Achieving a vIGA-AD of 0 or 1 With a Reduction From Baseline of ≥ 2 Points at Week 1667.4 percentage of participants
p-value: <0.00195% CI: [41.4, 69.5]Cochran-Mantel-Haenszel
p-value: <0.00195% CI: [12.1, 40.4]Cochran-Mantel-Haenszel
Secondary

Adolescents: Percent Change From Baseline in EASI Score at Week 16

EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1)\] moderate \[2\], or severe \[3\]) for Redness (erythema, inflammation), Thickness (induration, papulation, swelling - acute eczema), Scratching (excoriation), and Lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease; a negative change from Baseline indicates improvement.

Time frame: Baseline and Week 16

Population: Intent-to-treat population for adolescents with non-missing Baseline and Week 16 values; missing data were handled using a mixed-effect model with repeated measurements including observed measurements at all visits, except that measurements after any rescue medication were excluded.

ArmMeasureValue (LEAST_SQUARES_MEAN)
Placebo + Topical CorticosteroidsAdolescents: Percent Change From Baseline in EASI Score at Week 16-53.53 percent change
Upadacitinib 15 mg + Topical CorticosteroidsAdolescents: Percent Change From Baseline in EASI Score at Week 16-77.90 percent change
Upadacitinib 30 mg + Topical CorticosteroidsAdolescents: Percent Change From Baseline in EASI Score at Week 16-89.22 percent change
p-value: <0.00195% CI: [-46.28, -25.11]Mixed Effect Model Repeated Measurement
p-value: <0.00195% CI: [-35.1, -13.65]Mixed Effect Model Repeated Measurement
Secondary

Adolescents: Percent Change From Baseline in Worst Pruritus NRS at Week 16

Participants were asked to rate itch (pruritus) intensity at its worst during the past 24 hours on a daily basis using an 11-point scale from 0 (no itch) to 10 (worst imaginable itch). Pruritus NRS was analyzed based on weekly rolling averages of daily scores. A negative change from Baseline indicates improvement.

Time frame: Baseline (last available rolling average before the first dose of study drug) and Week 16

Population: Intent-to-treat population for adolescents with non-missing Baseline and Week 16 values; missing data were handled using a mixed-effect model with repeated measurements including observed measurements at all visits, except that measurements after any rescue medication were excluded.

ArmMeasureValue (LEAST_SQUARES_MEAN)
Placebo + Topical CorticosteroidsAdolescents: Percent Change From Baseline in Worst Pruritus NRS at Week 16-32.96 percent change
Upadacitinib 15 mg + Topical CorticosteroidsAdolescents: Percent Change From Baseline in Worst Pruritus NRS at Week 16-59.34 percent change
Upadacitinib 30 mg + Topical CorticosteroidsAdolescents: Percent Change From Baseline in Worst Pruritus NRS at Week 16-49.02 percent change
p-value: 0.1895% CI: [-39.59, 7.48]Mixed Effect Model Repeated Measurement
p-value: 0.02995% CI: [-49.97, -2.79]Mixed Effect Model Repeated Measurement
Secondary

Main Study: Percentage of Participants Achieving a 100% Reduction From Baseline in EASI Score (EASI 100) at Week 16

EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored from 0 \[none\], to 3 \[severe\]) for redness, thickness, scratching, and lichenification. The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease. The percentage of participants with an EASI 100 response at Week 16 was pre-specified as a ranked secondary endpoint for participants in the Upadacitinib 30 mg + Topical Corticosteroids group versus Placebo + Topical Corticosteroids group only.

Time frame: Baseline and Week 16

Population: Intent-to-treat population for the main study; Non-responder imputation incorporating multiple imputation to handle missing data due to COVID-19 (NRI-C) was used.

ArmMeasureValue (NUMBER)
Placebo + Topical CorticosteroidsMain Study: Percentage of Participants Achieving a 100% Reduction From Baseline in EASI Score (EASI 100) at Week 161.3 percentage of participants
Upadacitinib 15 mg + Topical CorticosteroidsMain Study: Percentage of Participants Achieving a 100% Reduction From Baseline in EASI Score (EASI 100) at Week 1612.0 percentage of participants
Upadacitinib 30 mg + Topical CorticosteroidsMain Study: Percentage of Participants Achieving a 100% Reduction From Baseline in EASI Score (EASI 100) at Week 1622.6 percentage of participants
p-value: <0.00195% CI: [16.3, 26.1]Cochran-Mantel-Haenszel
Secondary

Main Study: Percentage of Participants Achieving a 90% Reduction From Baseline in EASI Score (EASI 90) at Week 16

EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/ neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease.

Time frame: Baseline and Week 16

Population: Intent-to-treat population for the main study; Non-responder imputation incorporating multiple imputation to handle missing data due to COVID-19 (NRI-C) was used.

ArmMeasureValue (NUMBER)
Placebo + Topical CorticosteroidsMain Study: Percentage of Participants Achieving a 90% Reduction From Baseline in EASI Score (EASI 90) at Week 1613.2 percentage of participants
Upadacitinib 15 mg + Topical CorticosteroidsMain Study: Percentage of Participants Achieving a 90% Reduction From Baseline in EASI Score (EASI 90) at Week 1642.8 percentage of participants
Upadacitinib 30 mg + Topical CorticosteroidsMain Study: Percentage of Participants Achieving a 90% Reduction From Baseline in EASI Score (EASI 90) at Week 1663.1 percentage of participants
p-value: <0.00195% CI: [43.3, 56.4]Cochran-Mantel-Haenszel
p-value: <0.00195% CI: [22.8, 36.3]Cochran-Mantel-Haenszel
Secondary

Main Study: Percentage of Participants Achieving an EASI 75 Response at Week 2

EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease. An EASI 75 response is defined as at least a 75% reduction (improvement) from Baseline in EASI score.

Time frame: Baseline and Week 2

Population: Intent-to-treat population for the main study; Non-responder imputation incorporating multiple imputation to handle missing data due to COVID-19 (NRI-C) was used.

ArmMeasureValue (NUMBER)
Placebo + Topical CorticosteroidsMain Study: Percentage of Participants Achieving an EASI 75 Response at Week 26.9 percentage of participants
Upadacitinib 15 mg + Topical CorticosteroidsMain Study: Percentage of Participants Achieving an EASI 75 Response at Week 231.0 percentage of participants
Upadacitinib 30 mg + Topical CorticosteroidsMain Study: Percentage of Participants Achieving an EASI 75 Response at Week 244.1 percentage of participants
p-value: <0.00195% CI: [31, 43.3]Cochran-Mantel-Haenszel
p-value: <0.00195% CI: [18.1, 29.9]Cochran-Mantel-Haenszel
Secondary

Main Study: Percentage of Participants Achieving an EASI 75 Response at Week 4

EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease. An EASI 75 response is defined as at least a 75% reduction (improvement) from Baseline in EASI score.

Time frame: Baseline and Week 4

Population: Intent-to-treat population for the main study; Non-responder imputation incorporating multiple imputation to handle missing data due to COVID-19 (NRI-C) was used.

ArmMeasureValue (NUMBER)
Placebo + Topical CorticosteroidsMain Study: Percentage of Participants Achieving an EASI 75 Response at Week 414.8 percentage of participants
Upadacitinib 15 mg + Topical CorticosteroidsMain Study: Percentage of Participants Achieving an EASI 75 Response at Week 458.7 percentage of participants
Upadacitinib 30 mg + Topical CorticosteroidsMain Study: Percentage of Participants Achieving an EASI 75 Response at Week 472.4 percentage of participants
p-value: <0.00195% CI: [51.2, 63.9]Cochran-Mantel-Haenszel
p-value: <0.00195% CI: [37, 50.5]Cochran-Mantel-Haenszel
Secondary

Main Study: Percentage of Participants Achieving an EASI 90 Response at Week 4

EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/ neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1\], moderate \[2\], or severe \[3\]) for redness (erythema, inflammation), thickness (induration, papulation, swelling - acute eczema), scratching (excoriation), and lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease.

Time frame: Baseline and Week 4

Population: Intent-to-treat population for the main study; Non-responder imputation incorporating multiple imputation to handle missing data due to COVID-19 (NRI-C) was used.

ArmMeasureValue (NUMBER)
Placebo + Topical CorticosteroidsMain Study: Percentage of Participants Achieving an EASI 90 Response at Week 44.9 percentage of participants
Upadacitinib 15 mg + Topical CorticosteroidsMain Study: Percentage of Participants Achieving an EASI 90 Response at Week 428.3 percentage of participants
Upadacitinib 30 mg + Topical CorticosteroidsMain Study: Percentage of Participants Achieving an EASI 90 Response at Week 443.8 percentage of participants
p-value: <0.00195% CI: [32.8, 44.8]Cochran-Mantel-Haenszel
p-value: <0.00195% CI: [17.7, 28.9]Cochran-Mantel-Haenszel
Secondary

Main Study: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 1

Participants were asked to rate itch (pruritus) intensity at its worst during the past 24 hours on a daily basis using an 11-point scale from 0 (no itch) to 10 (worst imaginable itch). Pruritus NRS was analyzed based on weekly rolling averages of daily scores.

Time frame: Baseline (last available rolling average before the first dose of study drug) and Week 1

Population: Intent-to-treat population for the main study with Worst Pruritus NRS (weekly average) ≥ 4 at Baseline; Non-responder imputation incorporating multiple imputation to handle missing data due to COVID-19 (NRI-C) was used.

ArmMeasureValue (NUMBER)
Placebo + Topical CorticosteroidsMain Study: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 13.1 percentage of participants
Upadacitinib 15 mg + Topical CorticosteroidsMain Study: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 112.2 percentage of participants
Upadacitinib 30 mg + Topical CorticosteroidsMain Study: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 119.2 percentage of participants
p-value: <0.00195% CI: [11.3, 21.1]Cochran-Mantel-Haenszel
p-value: <0.00195% CI: [4.9, 13.4]Cochran-Mantel-Haenszel
Secondary

Main Study: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 4

Participants were asked to rate itch (pruritus) intensity at its worst during the past 24 hours on a daily basis using an 11-point scale from 0 (no itch) to 10 (worst imaginable itch). Pruritus NRS was analyzed based on weekly rolling averages of daily scores.

Time frame: Baseline (last available rolling average before the first dose of study drug) and Week 4

Population: Intent-to-treat population for the main study with Worst Pruritus NRS (weekly average) ≥ 4 at Baseline; Non-responder imputation incorporating multiple imputation to handle missing data due to COVID-19 (NRI-C) was used.

ArmMeasureValue (NUMBER)
Placebo + Topical CorticosteroidsMain Study: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 415.0 percentage of participants
Upadacitinib 15 mg + Topical CorticosteroidsMain Study: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 452.4 percentage of participants
Upadacitinib 30 mg + Topical CorticosteroidsMain Study: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus NRS at Week 465.6 percentage of participants
p-value: <0.00195% CI: [43.8, 57.3]Cochran-Mantel-Haenszel
p-value: <0.00195% CI: [30.4, 44.3]Cochran-Mantel-Haenszel
Secondary

Main Study: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus Numerical Rating Scale (NRS) at Week 16

Participants were asked to rate itch (pruritus) intensity at its worst during the past 24 hours on a daily basis using an 11-point scale from 0 (no itch) to 10 (worst imaginable itch). Pruritus NRS was analyzed based on weekly rolling averages of daily scores.

Time frame: Baseline (last available rolling average before the first dose of study drug) and Week 16

Population: Intent-to-treat population for the main study with Worst Pruritus NRS (weekly average) ≥ 4 at Baseline; Non-responder imputation incorporating multiple imputation to handle missing data due to COVID-19 (NRI-C) was used.

ArmMeasureValue (NUMBER)
Placebo + Topical CorticosteroidsMain Study: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus Numerical Rating Scale (NRS) at Week 1615.0 percentage of participants
Upadacitinib 15 mg + Topical CorticosteroidsMain Study: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus Numerical Rating Scale (NRS) at Week 1651.7 percentage of participants
Upadacitinib 30 mg + Topical CorticosteroidsMain Study: Percentage of Participants Achieving a Reduction of ≥ 4 Points From Baseline in Worst Pruritus Numerical Rating Scale (NRS) at Week 1663.9 percentage of participants
p-value: <0.00195% CI: [41.9, 55.7]Cochran-Mantel-Haenszel
p-value: <0.00195% CI: [29.7, 43.8]Cochran-Mantel-Haenszel
Secondary

Main Study: Percent Change From Baseline in EASI Score at Week 16

EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none \[0\], mild \[1)\] moderate \[2\], or severe \[3\]) for Redness (erythema, inflammation), Thickness (induration, papulation, swelling - acute eczema), Scratching (excoriation), and Lichenification (lined skin, prurigo nodules - chronic eczema). The total EASI score for each region is calculated by multiplying the severity score by the area score, with adjustment for the proportion of the body region to the whole body. The final EASI score is the sum of the 4 region scores and ranges from 0 to 72 where higher scores represent worse disease; a negative change from Baseline indicates improvement.

Time frame: Baseline and Week 16

Population: Intent-to-treat population for the main study with non-missing Baseline and Week 16 values; missing data were handled using a mixed-effect model with repeated measurements (MMRM) including observed measurements at all visits, except that measurements after any rescue medication were excluded.

ArmMeasureValue (LEAST_SQUARES_MEAN)
Placebo + Topical CorticosteroidsMain Study: Percent Change From Baseline in EASI Score at Week 16-45.86 percent change
Upadacitinib 15 mg + Topical CorticosteroidsMain Study: Percent Change From Baseline in EASI Score at Week 16-77.99 percent change
Upadacitinib 30 mg + Topical CorticosteroidsMain Study: Percent Change From Baseline in EASI Score at Week 16-87.31 percent change
Comparison: The overall type I error rate of the coprimary and all key secondary endpoints for upadacitinib 30 mg was controlled at the 0.05 level using a graphical multiple testing procedure following a pre-specified α transfer path which includes downstream transfer along the endpoints sequence within each dose as well as cross-dose transfer. This endpoint was a multiplicity-controlled key secondary endpoint for EU/EMA regulatory purposes only.p-value: <0.00195% CI: [-46.68, -36.22]Mixed Effect Model Repeated Measurement
p-value: <0.00195% CI: [-37.35, -26.91]Mixed Effect Model Repeated Measurement
Secondary

Main Study: Percent Change From Baseline in Worst Pruritus NRS at Week 16

Participants were asked to rate itch (pruritus) intensity at its worst during the past 24 hours on a daily basis using an 11-point scale from 0 (no itch) to 10 (worst imaginable itch). Pruritus NRS was analyzed based on weekly rolling averages of daily scores. A negative change from Baseline indicates improvement.

Time frame: Baseline (last available rolling average before the first dose of study drug) and Week 16

Population: Intent-to-treat population for the main study with non-missing Baseline and Week 16 values; missing data were handled using a mixed-effect model with repeated measurements (MMRM) including observed measurements at all visits, except that measurements after any rescue medication were excluded.

ArmMeasureValue (LEAST_SQUARES_MEAN)
Placebo + Topical CorticosteroidsMain Study: Percent Change From Baseline in Worst Pruritus NRS at Week 16-25.07 percent change
Upadacitinib 15 mg + Topical CorticosteroidsMain Study: Percent Change From Baseline in Worst Pruritus NRS at Week 16-58.14 percent change
Upadacitinib 30 mg + Topical CorticosteroidsMain Study: Percent Change From Baseline in Worst Pruritus NRS at Week 16-66.85 percent change
p-value: <0.00195% CI: [-50.46, -33.11]Mixed Effect Model Repeated Measurement
p-value: <0.00195% CI: [-41.72, -24.44]Mixed Effect Model Repeated Measurement

Source: ClinicalTrials.gov · Data processed: Mar 12, 2026