Physician Views: Asking dermatologists to assess AbbVie's promising atopic dermatitis data for upadacitinib

Rapid adoption of Regeneron Pharmaceuticals and Sanofi's new atopic dermatitis therapy Dupixent will side-line use of older systemic therapies in moderate-to-severe patients, argue key opinion leaders. But within the next few years, Dupixent could face new competition, as signposted by clinical data recently unveiled by AbbVie for its JAK inhibitor upadacitinib. Yes, this data is from a smaller Phase IIb trial – Phase III studies should commence next year – and the safety profiles of JAK inhibitors have recently come under some scrutiny, but efficacy looks comparable to that of Dupixent, while upadacitinib can also be administered as a tablet (as opposed to subcutaneous injection).

Given early excitement around the upadacitinib data we are snap-polling US and EU5 dermatologists for feedback, specifically asking them…

In a Phase IIb study, three doses of the oral JAK inhibitor upadacitinib were shown (when administered once daily) to achieve the primary endpoint of greater mean percentage change from baseline in Eczema Area and Severity Index (EASI) score versus placebo at 16 weeks in patients with moderate-to-severe atopic dermatitis. This was achieved by 74/62/39 percent of patients receiving 30/15/7.5 mg doses of upadacitinib, respectively, compared to 23 percent for patients receiving placebo. Each upadacitinib arm comprised 42 patients with 41 in the placebo arm.

How compelling are these results?

Very uncompelling

Moderately uncompelling

Slightly uncompelling

Neither compelling or uncompelling

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Very compelling

A 75 percent improvement in disease (EASI 75) was achieved by 69/52/29 percent of patients receiving the 30/15/7.5 mg doses of upadacitinib respectively, compared to 10 percent for patients receiving placebo. Disease improvement of 90 percent or more (EASI 90) was achieved by 50/26/14 percent of patients receiving the 30/15/7.5 mg doses of upadacitinib, respectively, compared to 2 percent for patients receiving placebo.

How compelling are these results?

Very uncompelling

Moderately uncompelling

Slightly uncompelling

Neither compelling or uncompelling

Slightly compelling

Moderately compelling

Very compelling

Clear or almost clear skin was achieved by 50/31/14 percent of patients receiving the 30/15/7.5 mg doses of upadacitinib, respectively, as measured by the Investigator's Global Assessment scale (IGA 0 or 1), compared to 2 percent of patients receiving placebo.

How compelling are these results?

Very uncompelling

Moderately uncompelling

Slightly uncompelling

Neither compelling or uncompelling

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Very compelling

Significant improvement was observed with respect to pruritus (itch). Patients treated with upadacitinib experienced 69/48/40 percent improvement in itch across the 30/15/7.5 mg upadacitinib doses, respectively, as measured by the pruritus numerical rating scale (NRS), compared to 10 percent for patients receiving placebo.

How compelling are these results?

Very uncompelling

Moderately uncompelling

Slightly uncompelling

Neither compelling or uncompelling

Slightly compelling

Moderately compelling

Very compelling

If upadacitinib (dosed orally) was to demonstrate similar efficacy in Phase III studies, what competitive threat would it pose to Dupixent (dupilumab; dosed with subcutaneous injection) in the moderate-to-severe atopic dermatitis market?

None

Marginal

Moderate

Significant

Very significant 

Results and related analysis will shortly be published for FirstWord Pharma PLUS subscribers to read, with the opportunity for non-FirstWord Pharma PLUS subscribers to purchase these findings. To be notified when poll results and analysis become available, please click here.

As always, FirstWord would very much like to receive your feedback and suggestions. Note: FirstWord Polls are powered by Medefield MedePolls, a fast-turnaround service to conduct instant polls of up to five questions with guaranteed samples that include physicians from dozens of specialties and over 100 markets. To conduct this poll with a different audience, or an entirely different poll, contact us at info@firstwordpharma.com.

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