Christopher Bunick, MD, PhD: Latest Data on Upadacitinib for Atopic Dermatitis

In this HCPLive interview, Christopher Bunick, MD, PhD, discussed the long-term, 4-year safety of the drug upadacitinib in treating patients with moderate-to-severe atopic dermatitis (AD).

Bunick is known for his work as an Associate Professor of Dermatology at the Yale School of Medicine, as well as his research studying the 3-dimensional structures of skin-related proteins through the use of x-ray crystallography and using cryo-electron microscopy.

This new late breaking data on upadacitinib was presented by Bunick at the Revolutionizing Atopic Dermatitis (RAD) 2023 Annual Meeting in Washington, DC.

“So the 1 year safety data of upadacitinib showed that upadactinib was overall a very safe medicine, and upadacitinib is a JAK1 selective inhibitor,” he explained. “But under the umbrella of JAK inhibitors, there's been a concern in dermatology about how safe they are mainly because the FDA put a so-called black box warning onto this class of medications.”

He then pointed out that despite these concerns, the 1 year safety data of the drug has shown to be favorable, with a strong safety profile and low rates of concerning events such as cardiovascular events, clotting events, and malignancies.

“It actually represents the longest safety analysis for the longest period of time analyzing safety of a JAK inhibitor approved for atopic dermatitis,” he stated. “So I think this data is very essential to helping dermatologists understand that when they're prescribing a JAK inhibitor, particularly upadacitinib to their atopic dermatitis patients, they can feel confident that the data stands behind its safety.”

Bunick also went into some unique elements to the results, including facts about patient demographics.

“It is easy to sometimes criticize studies and say that the patients were cherry picked (and) the patients don't represent the average population that we may be using these medicines in,” he said. “But what was really fascinating about the 4 year upadacitinib safety data, which included over 3000 patient years of experience, what was fascinating was it really, in my opinion, captured real world, 21st century human beings.”

The reason for this view, he explained, was that around 60% of the patients included in the study had cardiovascular risk factors, including a history of hypertension, a history of diabetes, a prior history of cardiovascular events, etc.

“This is really, really exciting, because it gives dermatologists confidence that despite a box warning, this medicine is proving to be safer and safer,” Bunick said. “The longer it's used in patients, the longer that we have data of how patients do when they use it long term.”

For more information about this late breaking data presentation, view the full interview segment above.