Trial reportAmerican journal of clinical dermatology2026
Switching from Dupilumab to Upadacitinib in Adults and Adolescents with Moderate-to-Severe Atopic Dermatitis After Inadequate Response to Dupilumab: Efficacy and Safety Results from Period 2 of Phase 3b/4 Study (LEVEL UP).
Trial report in American journal of clinical dermatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05601882 (A Phase 3b/4 Randomized, Open-label, Efficacy Assessor Blinded Study, Comparing the Safety and Assessor Blinded Efficacy of Upadacitinib to Dupilumab in Subjects With Moderate to Severe Atopic Dermatitis), which is not on this map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Phase 3b/4 Randomized, Open-label, Efficacy Assessor Blinded Study, Comparing the Safety and Assessor Blinded Efficacy of Upadacitinib to Dupilumab in Subjects With Moderate to Severe Atopic Dermatitis (Level-Up)
Who cites it
4 citing papers in PubMed.
- Real-World Evidence of Upadacitinib in Atopic Dermatitis after Inadequate Response or Intolerance to Dupilumab: The CAN UpTIMISE Study.Dermatology and therapy · 2026Article
- Atopic Dermatitis Beyond the Skin Barrier: Precision Medicine Approaches to Immunological Profiling and Therapeutic Innovation.International journal of molecular sciences · 2026Review
- Lebrikizumab Improves Clinical Manifestations, Symptoms, and Quality of Life in Patients with Moderate-to-Severe Atopic Dermatitis Previously Treated with Dupilumab: Results from the ADapt Study.Dermatology and therapy · 2026Article
- JAK-STAT pathway-associated skin diseases: a refined functional framework for inflammatory skin diseases.Frontiers in immunology · 2026Review
Corrections and comments
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAtopic dermatitis (AD) is a chronic inflammatory skin disease characterized by intense itch and eczematous skin lesions. Upadacitinib, a selective oral Janus kinase inhibitor, and dupilumab, a monoclonal antibody, are both approved treatments for moderate-to-severe AD. In period 1 of the LEVEL UP phase 3b/4 head-to-head study, upadacitinib-treated patients demonstrated higher simultaneous achievement of near complete skin clearance and little to no itch compared with dupilumab after 16 weeks of treatment in adults and adolescents with moderate-to-severe AD.
objectiveThe objective of period 2 of the LEVEL UP study was to assess the efficacy and safety of switching from dupilumab to upadacitinib in patients with inadequate response to dupilumab.
methodsFollowing period 1 of the LEVEL UP study, patients not achieving ≥ 75% improvement in the Eczema Area and Severity Index (EASI 75) from baseline at week 16 entered an additional 16-week extension phase (period 2). In period 2, patients receiving dupilumab were switched to upadacitinib 15 mg, with the potential to escalate to 30 mg based on clinical response. End points in period 2 included EASI 90, Worst Pruritus Numerical Rating Scale (WP-NRS) 0/1, and simultaneous achievement of both EASI 90 and WP-NRS 0/1 at week 20 and week 32.
resultsA total of 208 patients were switched from dupilumab to upadacitinib, entering period 2 of the study. At week 32, response rates for patients who switched were: 79.6%, 58.7%, and 19.9% achieving EASI 75, EASI 90, and EASI 100, respectively; 60.2% achieving Worst Pruritus Numerical Rating Scale improvement ≥ 4 among those with baseline WP-NRS ≥ 4; 37.0% achieving WP-NRS 0/1 among those with baseline WP-NRS > 1; and 26.8% simultaneously achieving EASI 90 and WP-NRS 0/1. Clinically, meaningful outcomes were also observed at week 20. No new safety signals were identified compared with the established safety profile of upadacitinib.
conclusionsThe current findings suggest that switching from dupilumab to upadacitinib may be an effective treatment strategy for patients who do not meet moderate-to-optimal treatment targets with dupilumab. CLINICAL
trial registrationLEVEL UP (NCT05601882).
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