Durability of Patient-Reported Outcomes in AD: 140-Week Results From Measure Up 1 and 2

Long-term follow-up from the phase 3 Measure Up 1 (NCT03569293) and Measure Up 2 (NCT03607422) trials offered further insight into the durability of patient-centered benefits with upadacitinib in atopic dermatitis (AD).¹ According to the poster, which was presented at the 2026 American Academy of Dermatology Annual Meeting, early improvements in symptoms and quality of life can be sustained for up to 140 weeks. This post hoc analysis shifts the focus from initial response to long-term stability, examining whether patients who achieve stringent patient-reported outcomes (PROs) maintain these gains over time.

Although short-term efficacy is essential, long-term disease control is a critical goal in clinical management for patients with moderate to severe AD. Contemporary treatment frameworks, including the Aiming High in Eczema/Atopic Dermatitis (AHEAD) recommendations, emphasize sustained achievement of low disease burden across multiple domains, particularly those reported directly by patients.

Methods and Materials

This analysis included adolescents and adults who were originally randomly assigned to receive once-daily oral upadacitinib (15 mg or 30 mg) and continued therapy through 140 weeks.² Investigators specifically evaluated patients who had already reached stringent PRO thresholds at week 16, assessing whether these outcomes persisted over extended follow-up.

Stringent PRO responses were defined using well-established instruments and reflected minimal or no disease impact, including the following:

• Worst Pruritus Numeric Rating Scale score of 0 or 1 for itch
• Dermatology Life Quality Index (DLQI) or children’s DLQI scores of 0 or 1 for quality of life
• AD Impact Scale low-impact scores (sleep, daily activities, emotional well-being, and other domains)

High treatment satisfaction, defined as “very” or “extremely” satisfied on the Patient Global Impression of Treatment, was also considered a key outcome. Initial response rates at week 16 were robust, particularly among patients receiving the 30-mg dose, with a substantial proportion achieving minimal itch, negligible impact on quality of life, and high levels of treatment satisfaction.

Positive PRO Responses

Across both dosing groups, most patients who achieved stringent PRO responses at week 16 maintained these outcomes through week 140. Approximately 90% of patients sustained at least a moderate level of response—indicating continued symptom control with only mild residual burden—whereas a large proportion, generally ranging from 60% to 80%, maintained stringent responses across the key domains.

Importantly, the durability of response was consistent across multiple aspects of disease burden. Control of itch remained stable over time, with most patients continuing to report little to no pruritus. Sleep outcomes also showed sustained benefit, with patients maintaining low levels of sleep disruption over the 140-week period. Functional measures, including the ability to perform daily activities, remained largely unaffected in those maintaining stringent responses; emotional well-being also showed lasting improvement.

Treatment satisfaction and quality-of-life improvements remained high throughout the study period. Most patients continued to report being very or extremely satisfied with upadacitinib therapy. Notably, the trajectory of response remained stable over time, with similar rates of maintenance observed at intermediate assessments such as week 52 and at the final 140-week time point. This pattern indicates that, once achieved, stringent disease control with upadacitinib is generally durable rather than transient.

Conclusion

Although the 30-mg dose was associated with higher initial rates of stringent response, both dosing regimens demonstrated comparable long-term maintenance among responders. This suggests that patients who achieve early disease control—regardless of dose—have a high likelihood of sustaining these benefits with continued therapy. Additionally, the data support the role of upadacitinib as a maintenance therapy capable of preserving low disease burden across multiple domains that matter most to patients.

References

1. Bunick C, Chovatiya R, Torres T, et al. Long-term maintenance of stringent patient-reported outcomes with upadacitinib in moderate-to-severe atopic dermatitis: 140-week results from the Measure Up 1 and 2 phase 3 studies. Presented at: 2026 American Academy of Dermatology Annual Meeting; March 27-31, 2026; Denver, CO.

2. Issa NT, Chovatiya R, Talia J, et al. Long-term maintenance of optimal treatment targets for skin and itch outcomes with upadacitinib in moderate-to-severe atopic dermatitis: 140-week results from the phase 3 Measure Up 1 and 2 studies. J of Skin. 2024;8(6):s449. doi:10.25251/skin.8.supp.449