Upadacitinib 30 mg Ranks Most Effective Among Targeted Therapies for Atopic Dermatitis Without Topical Corticosteroids
An updated network meta-analysis (NMA) of phase 3 trials suggests that upadacitinib 30 mg provides the highest efficacy among targeted therapies for moderate-to-severe atopic dermatitis (AD) when used without concomitant topical corticosteroids.
The analysis included 14 randomized controlled trials comprising 12,916 patients. A Bayesian random-effects model was used to estimate treatment effects, incorporating both direct and indirect comparisons. Outcomes included Eczema Area and Severity Index (EASI) 90, EASI 75, itch reduction (Numerical Rating Scale [NRS]), combined skin and itch endpoints (EASI 90 + NRS 0/1), and Investigator Global Assessment 0/1 at weeks 12 or 16.
All therapies demonstrated superiority over placebo across evaluated endpoints. However, upadacitinib 30 mg consistently ranked highest across most outcomes. Upadacitinib 30 mg achieved the highest odds ratios and surface under the cumulative ranking (SUCRA) scores for key endpoints, including EASI 90 (OR 20.3; SUCRA 96.2%) and EASI 90 + NRS 0/1 (OR 36.7; SUCRA 96.2%).
For itch control, upadacitinib 30 mg also demonstrated superior performance (NRS 0/1 OR 16.6; SUCRA 94.3%). The only exception was the EASI 75 endpoint, where a step-up regimen of upadacitinib showed the highest ranking (SUCRA 96.0%).
“The updated network meta-analysis (NMA) analyzed 14 trials involving 12916 patients… All therapeutic regimens demonstrated statistically significant superiority over placebo,” the author stated. “Among targeted therapies for moderate-to-severe AD without concomitant topical corticosteroids… upadacitinib 30 mg demonstrated the most efficacious in this NMA.”
These findings reinforce upadacitinib 30 mg as a leading systemic option for achieving rapid and high-level disease control in AD, particularly in treatment settings where topical corticosteroids are not used.
Reference
Ji S. Comparative efficacy of targeted therapies for moderate-to-severe atopic dermatitis without topical corticosteroids: an updated network meta-analysis. Presented at: American Academy of Dermatology Annual Meeting; March 27–31, 2026; Denver, Colorado.
