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NCT05507580: Flex-Up

A Study to Assess Treat-to-Target and Dosing Flexibility of Oral Upadacitinib Tablets in Adult Participants With Moderate to Severe Atopic Dermatitis

Completed Phase 4 Results posted Last updated 29 July 2025
What this trial tests

Phase 4 trial testing Upadacitinib in Atopic Dermatitis in 461 participants. Completed in 15 August 2024.

Timeline
29 May 2023
Primary endpoint
11 July 2024
15 August 2024

Quick facts

Lead sponsorAbbVie
PhasePhase 4
StatusCompleted
Study typeINTERVENTIONAL
Allocationrandomized
Designsequential
Maskingquadruple
Primary purposetreatment
Enrollment461
Start date29 May 2023
Primary completion11 July 2024
Estimated completion15 August 2024
Sites106 locations across Italy, New Zealand, Japan, Netherlands, Slovakia, Belgium, Taiwan, United Kingdom

Drugs / interventions tested

Conditions studied

Sponsor

AbbVie — full company profile →

Who can join

Adults 18 to 64, any sex, with Atopic Dermatitis. Patients with the condition only — healthy volunteers not accepted.

Results — posted to ClinicalTrials.gov

Per-arm endpoint measurements with 95% confidence intervals where reported. Source: trial results section.

Percentage of Participants Achieving ≥ 90% Reduction From Baseline in Eczema Area and Severity Index Score (EASI 90) at Week 24 Primary · Baseline and Week 24

The EASI is a composite index with scores ranging from 0 to 72. Four atopic dermatitis (AD) disease characteristics (erythema, thickness \[induration, papulation, edema\], scratching \[excoriation\], and lichenification) are assessed for severity on a scale of "0" (absent) through "3" (severe). In addition, the area of AD involvement is assessed as a percentage by body area of head, trunk (including the genital area), upper extremities, and lower extremities (including the buttocks), and converted to a score of 0 to 6. In each body region, the area is expressed as 0, 1 (1% to 9%), 2 (10% to 29

GroupValue95% CI
UPA 15 mg Double-Blind Treatment Period --> UPA 15 mg Single-Blind Treatment Period74.664.5 – 84.8
UPA 15 mg Double-Blind Treatment Period --> UPA 30 mg Single-Blind Treatment Period48.139.6 – 56.6
UPA 30 mg Double-Blind Treatment Period --> UPA 15 mg Single-Blind Treatment Period68.560.5 – 76.4
UPA 30 mg Double-Blind Treatment Period --> UPA 30 mg Single-Blind Treatment Period29.319.4 – 39.1
Percentage of Participants Achieving ≥ 75% Reduction From Baseline in Eczema Area and Severity Index Score (EASI 75) at Week 24 Secondary · Baseline and Week 24

The EASI is a composite index with scores ranging from 0 to 72. Four atopic dermatitis (AD) disease characteristics (erythema, thickness \[induration, papulation, edema\], scratching \[excoriation\], and lichenification) are assessed for severity on a scale of "0" (absent) through "3" (severe). In addition, the area of AD involvement is assessed as a percentage by body area of head, trunk (including the genital area), upper extremities, and lower extremities (including the buttocks), and converted to a score of 0 to 6. In each body region, the area is expressed as 0, 1 (1% to 9%), 2 (10% to 29

GroupValue95% CI
UPA 15 mg Double-Blind Treatment Period --> UPA 15 mg Single-Blind Treatment Period97.293.3 – 100.0
UPA 15 mg Double-Blind Treatment Period --> UPA 30 mg Single-Blind Treatment Period69.261.3 – 77.0
UPA 30 mg Double-Blind Treatment Period --> UPA 15 mg Single-Blind Treatment Period88.583.0 – 94.0
UPA 30 mg Double-Blind Treatment Period --> UPA 30 mg Single-Blind Treatment Period52.441.6 – 63.2
Percentage of Participants Achieving a 100% Reduction From Baseline in Eczema Area and Severity Index Score (EASI 100) at Week 24 Secondary · Baseline and Week 24

The EASI is a composite index with scores ranging from 0 to 72. Four atopic dermatitis (AD) disease characteristics (erythema, thickness \[induration, papulation, edema\], scratching \[excoriation\], and lichenification) are assessed for severity on a scale of "0" (absent) through "3" (severe). In addition, the area of AD involvement is assessed as a percentage by body area of head, trunk (including the genital area), upper extremities, and lower extremities (including the buttocks), and converted to a score of 0 to 6. In each body region, the area is expressed as 0, 1 (1% to 9%), 2 (10% to 29

GroupValue95% CI
UPA 15 mg Double-Blind Treatment Period --> UPA 15 mg Single-Blind Treatment Period33.822.8 – 44.8
UPA 15 mg Double-Blind Treatment Period --> UPA 30 mg Single-Blind Treatment Period7.53.0 – 12.0
UPA 30 mg Double-Blind Treatment Period --> UPA 15 mg Single-Blind Treatment Period21.514.5 – 28.6
UPA 30 mg Double-Blind Treatment Period --> UPA 30 mg Single-Blind Treatment Period3.70.0 – 7.7
Percentage of Participants Achieving ≥ 75% Reduction From Baseline in Eczema Area and Severity Index Score (EASI 75) at Week 12 Secondary · Baseline and Week 12

The EASI is a composite index with scores ranging from 0 to 72. Four atopic dermatitis (AD) disease characteristics (erythema, thickness \[induration, papulation, edema\], scratching \[excoriation\], and lichenification) are assessed for severity on a scale of "0" (absent) through "3" (severe). In addition, the area of AD involvement is assessed as a percentage by body area of head, trunk (including the genital area), upper extremities, and lower extremities (including the buttocks), and converted to a score of 0 to 6. In each body region, the area is expressed as 0, 1 (1% to 9%), 2 (10% to 29

GroupValue95% CI
UPA 15 mg Double-Blind Treatment Period64.458.1 – 70.7
UPA 30 mg Double-Blind Treatment Period79.374.0 – 84.6
Percentage of Participants Achieving ≥ 90% Reduction From Baseline in Eczema Area and Severity Index Score (EASI 90) at Week 12 Secondary · Baseline and Week 12

The EASI is a composite index with scores ranging from 0 to 72. Four atopic dermatitis (AD) disease characteristics (erythema, thickness \[induration, papulation, edema\], scratching \[excoriation\], and lichenification) are assessed for severity on a scale of "0" (absent) through "3" (severe). In addition, the area of AD involvement is assessed as a percentage by body area of head, trunk (including the genital area), upper extremities, and lower extremities (including the buttocks), and converted to a score of 0 to 6. In each body region, the area is expressed as 0, 1 (1% to 9%), 2 (10% to 29

GroupValue95% CI
UPA 15 mg Double-Blind Treatment Period33.827.6 – 40.0
UPA 30 mg Double-Blind Treatment Period59.953.5 – 66.3
Percentage of Participants Achieving a 100% Reduction From Baseline in Eczema Area and Severity Index Score (EASI 100) at Week 12 Secondary · Baseline and Week 12

The EASI is a composite index with scores ranging from 0 to 72. Four atopic dermatitis (AD) disease characteristics (erythema, thickness \[induration, papulation, edema\], scratching \[excoriation\], and lichenification) are assessed for severity on a scale of "0" (absent) through "3" (severe). In addition, the area of AD involvement is assessed as a percentage by body area of head, trunk (including the genital area), upper extremities, and lower extremities (including the buttocks), and converted to a score of 0 to 6. In each body region, the area is expressed as 0, 1 (1% to 9%), 2 (10% to 29

GroupValue95% CI
UPA 15 mg Double-Blind Treatment Period7.74.2 – 11.2
UPA 30 mg Double-Blind Treatment Period15.911.1 – 20.6
Percentage of Participants Achieving a ≥ 90% Reduction From Baseline in Eczema Area and Severity Index Score (EASI 90) and Worst Pruritus Numerical Rating Scale of 0 or 1 (WP-NRS 0/1) at Week 12 Among Those With WP-NRS > 1 at Baseline Secondary · Baseline and Week 12

The EASI is a composite index with scores ranging from 0 to 72. Four atopic dermatitis (AD) disease characteristics (erythema, thickness \[induration, papulation, edema\], scratching \[excoriation\], and lichenification) assessed for severity on a scale of "0" (absent) through "3" (severe). In addition, the area of AD involvement is assessed as a percentage by body area of head, trunk (including the genital area), upper extremities, and lower extremities (including the buttocks), and converted to a score of 0 to 6. In each body region, the area is expressed as 0, 1 (1% to 9%), 2 (10% to 29%),

GroupValue95% CI
UPA 15 mg Double-Blind Treatment Period18.012.5 – 23.6
UPA 30 mg Double-Blind Treatment Period32.525.9 – 39.1
Percentage of Participants Achieving a ≥ 90% Reduction From Baseline in Eczema Area and Severity Index Score (EASI 90) and Worst Pruritus Numerical Rating Scale of 0 or 1 (WP-NRS 0/1) at Week 24 Among Those With WP-NRS > 1 at Baseline Secondary · Baseline and Week 24

The EASI is a composite index with scores ranging from 0 to 72. Four atopic dermatitis (AD) disease characteristics (erythema, thickness \[induration, papulation, edema\], scratching \[excoriation\], and lichenification) assessed for severity on a scale of "0" (absent) through "3" (severe). In addition, the area of AD involvement is assessed as a percentage by body area of head, trunk (including the genital area), upper extremities, and lower extremities (including the buttocks), and converted to a score of 0 to 6. In each body region, the area is expressed as 0, 1 (1% to 9%), 2 (10% to 29%),

GroupValue95% CI
UPA 15 mg Double-Blind Treatment Period --> UPA 15 mg Single-Blind Treatment Period38.525.2 – 51.7
UPA 15 mg Double-Blind Treatment Period --> UPA 30 mg Single-Blind Treatment Period20.712.0 – 29.5
UPA 30 mg Double-Blind Treatment Period --> UPA 15 mg Single-Blind Treatment Period35.025.7 – 44.3
UPA 30 mg Double-Blind Treatment Period --> UPA 30 mg Single-Blind Treatment Period20.310.1 – 30.6
Percentage of Participants Achieving Validated Investigator Global Assessment for Atopic Dermatitis (vlGA-AD) of 0 or 1 at Week 12 Secondary · At Week 12

vIGA-AD is a validated assessment instrument used in clinical studies to rate the severity of AD globally. A 5-point scale is used to measure the severity of disease at the time of the investigator's evaluation of the participant ranging from 0 - Clear (no inflammatory signs of atopic dermatitis \[no erythema, no induration/papulation, no lichenification, no oozing/crusting\] Post-inflammatory hyperpigmentation and/or hypopigmentation may be present) to 4 - Severe (marked erythema \[deep or bright red\], marked induration/papulation, and/or marked lichenification).

GroupValue95% CI
UPA 15 mg Double-Blind Treatment Period29.723.7 – 35.7
UPA 30 mg Double-Blind Treatment Period51.545.0 – 58.0
Percentage of Participants Achieving Validated Investigator Global Assessment for Atopic Dermatitis (vlGA-AD) of 0 or 1 at Week 24 Secondary · At Week 24

vIGA-AD is a validated assessment instrument used in clinical studies to rate the severity of AD globally. A 5-point scale is used to measure the severity of disease at the time of the investigator's evaluation of the participant ranging from 0 - Clear (no inflammatory signs of atopic dermatitis \[no erythema, no induration/papulation, no lichenification, no oozing/crusting\] Post-inflammatory hyperpigmentation and/or hypopigmentation may be present) to 4 - Severe (marked erythema \[deep or bright red\], marked induration/papulation, and/or marked lichenification).

GroupValue95% CI
UPA 15 mg Double-Blind Treatment Period --> UPA 15 mg Single-Blind Treatment Period63.452.2 – 74.6
UPA 15 mg Double-Blind Treatment Period --> UPA 30 mg Single-Blind Treatment Period40.632.3 – 48.9
UPA 30 mg Double-Blind Treatment Period --> UPA 15 mg Single-Blind Treatment Period52.343.7 – 60.9
UPA 30 mg Double-Blind Treatment Period --> UPA 30 mg Single-Blind Treatment Period29.319.4 – 39.1
Percentage of Participants Achieving an Improvement (Reduction) in Worst Pruritus Numerical Rating Scale (WP-NRS) ≥4 at Week 12 Among Those With Baseline WP-NRS ≥4 Secondary · Baseline and Week 12

The Worst Pruritus NRS is an assessment tool that participants used to report the intensity of their pruritus during a 24-hour recall period using an electronic hand-held device. Participants rated itch (pruritus) intensity at its worst during the past 24 hours on an 11-point scale from 0 (no itch) to 10 (worst imaginable itch).

GroupValue95% CI
UPA 15 mg Double-Blind Treatment Period53.346.0 – 60.5
UPA 30 mg Double-Blind Treatment Period67.761.1 – 74.3
Percentage of Participants Achieving an Improvement (Reduction) in Worst Pruritus Numerical Rating Scale (WP-NRS) ≥4 at Week 24 Among Those With Baseline WP-NRS ≥4 Secondary · Baseline and Week 24

The Worst Pruritus NRS is an assessment tool that participants used to report the intensity of their pruritus during a 24-hour recall period using an electronic hand-held device. Participants rated itch (pruritus) intensity at its worst during the past 24 hours on an 11-point scale from 0 (no itch) to 10 (worst imaginable itch).

GroupValue95% CI
UPA 15 mg Double-Blind Treatment Period --> UPA 15 mg Single-Blind Treatment Period73.161.0 – 85.1
UPA 15 mg Double-Blind Treatment Period --> UPA 30 mg Single-Blind Treatment Period57.346.6 – 68.0
UPA 30 mg Double-Blind Treatment Period --> UPA 15 mg Single-Blind Treatment Period67.057.8 – 76.2
UPA 30 mg Double-Blind Treatment Period --> UPA 30 mg Single-Blind Treatment Period60.047.6 – 72.4

Adverse events — posted to ClinicalTrials.gov

Time frame: All-cause mortality and adverse event tables include events reported from the time informed consent was signed to the end of the study. The median time on follow-up was 168 days for the Double-Blind Treatment Period groups and ranged from 168 to 169 days for the Single-Blind Treatment Period groups.. Reporting threshold: 5%. Adverse-event reports describe events observed during the trial — not all are caused by the drug.

UPA 15 mg Double-Blind Treatment Period
Serious: 8/229 (3%)
Deaths: 0/229
UPA 30 mg Double-Blind Treatment Period
Serious: 0/232 (0%)
Deaths: 0/232
UPA 15 mg Double-Blind Treatment Period --> UPA 15 mg Single-Blind Treatment Period
Serious: 1/72 (1%)
Deaths: 0/72
UPA 15 mg Double-Blind Treatment Period --> UPA 30 mg Single-Blind Treatment Period
Serious: 1/144 (1%)
Deaths: 0/144
UPA 30 mg Double-Blind Treatment Period --> UPA 15 mg Single-Blind Treatment Period
Serious: 1/133 (1%)
Deaths: 0/133
UPA 30 mg Double-Blind Treatment Period --> UPA 30 mg Single-Blind Treatment Period
Serious: 0/91 (0%)
Deaths: 0/91

Serious adverse events (13 terms)

ReactionSystemUPA 15 mg Double-Blind Tre…UPA 30 mg Double-Blind Tre…UPA 15 mg Double-Blind Tre…UPA 15 mg Double-Blind Tre…UPA 30 mg Double-Blind Tre…UPA 30 mg Double-Blind Tre…
ACUTE MYOCARDIAL INFARCTIONCardiac disorders
CORONARY ARTERY DISEASECardiac disorders
TOXIC NODULAR GOITREEndocrine disorders
EPIDIDYMITISInfections and infestations
ERYSIPELASInfections and infestations
PYELONEPHRITISInfections and infestations
FALLInjury, poisoning and procedural complications
HAND FRACTUREInjury, poisoning and procedural complications
HUMERUS FRACTUREInjury, poisoning and procedural complications
SPINAL COMPRESSION FRACTUREInjury, poisoning and procedural complications
ASTHMARespiratory, thoracic and mediastinal disorders
DERMATITIS ATOPICSkin and subcutaneous tissue disorders
DERMATITIS EXFOLIATIVE GENERALISEDSkin and subcutaneous tissue disorders
Other adverse events (6 terms — click to expand)

ReactionSystemUPA 15 mg Double-Blind Tre…UPA 30 mg Double-Blind Tre…UPA 15 mg Double-Blind Tre…UPA 15 mg Double-Blind Tre…UPA 30 mg Double-Blind Tre…UPA 30 mg Double-Blind Tre…
ACNESkin and subcutaneous tissue disorders
DERMATITIS ATOPICSkin and subcutaneous tissue disorders
NASOPHARYNGITISInfections and infestations
UPPER RESPIRATORY TRACT INFECTIONInfections and infestations
ORAL HERPESInfections and infestations
ECZEMASkin and subcutaneous tissue disorders

Most-reported serious reactions: ACUTE MYOCARDIAL INFARCTION, CORONARY ARTERY DISEASE, TOXIC NODULAR GOITRE, EPIDIDYMITIS, ERYSIPELAS, PYELONEPHRITIS, FALL, HAND FRACTURE.

Data from ClinicalTrials.gov NCT05507580 adverse events section.

Sponsor's own description

Atopic dermatitis (AD) is a skin condition that may cause a rash and itching due to inflammation of the skin. Therapies spread over the skin may not be enough to control the AD in trial participants who require systemic anti-inflammatory treatment. This study evaluates the dosing flexibility of upadacitinib in adult participants with moderate to severe AD. Adverse events and change in the disease activity will be assessed. Upadacitinib is an approved drug for the treatment of moderate to severe/active immune-mediated inflammatory diseases such as rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, ulcerative colitis (UC), Crohn's Disease (CD), and AD. The study is comprised of a 35-day Screening Period, a 12-week double-blind period and a 12-week single-blind period. During the double-blind period, participants are placed in 1 of 2 groups, called treatment arms and will be randomized in a 1:1 ratio to receive upadacitinib. At 12 weeks during the single blind period, participants will be blinded to the upadacitinib dose based on their EASI response and reassigned to in 1 of 4 arms. After the last study visit, there is a 30-day follow-up visit. Approximately 454 adult participants ages 18 to 64 with moderate to severe AD who are candidates for systemic therapy will be enrolled at up to 160 sites worldwide. The study is comprised of a 12-week double-blind period, followed by a 12-week single-blind period. Participants will receive upadacitinib oral tablets once daily for up to 24 weeks. There may be higher treatment burden for participants in this trial compared to their standard of care (due to study procedures). Participants will attend regular visits during the study at a hospital or clinic. The effect of the treatment will be checked by medical assessments, blood tests, checking for side effects and completing questionnaires.

Publications & conference data

4 peer-reviewed publications reference this trial (live from Europe PMC):

  1. Novel Janus Kinase Inhibitors in the Treatment of Dermatologic Conditions.
    Ryguła I, Pikiewicz W, Kaminiów K. · · 2023 · cited 6× · PMID 38138551 · DOI 10.3390/molecules28248064
  2. Efficacy and Safety of Upadacitinib for Management of Moderate-to-Severe Atopic Dermatitis: An Evidence-Based Review.
    Lytvyn Y, Mufti A, Abduelmula A, Sachdeva M, et al · · 2022 · cited 4× · PMID 36432643 · DOI 10.3390/pharmaceutics14112452
  3. Efficacy and Safety of Upadacitinib in Patients With Moderate-to-Severe Atopic Dermatitis: Phase 3 Randomized Clinical Trial Results Through 140 Weeks.
    Irvine AD, Prajapati VH, Guttman-Yassky E, Simpson EL, et al · · 2025 · cited 3× · PMID 40900410 · DOI 10.1007/s40257-025-00975-3
  4. Innovations and Emerging Therapies in Atopic Dermatitis Part 1.
    Okereke R, Simpson E. · · 2025 · PMID 40547056 · DOI 10.1007/s40521-025-00390-3

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Drug Landscape aggregates and links these public records for informational use only. Always verify against the primary source before clinical or regulatory decisions. Canonical URL: https://druglandscape.com/trial/NCT05507580.

Primary sources · FDA · ClinicalTrials.gov · EMA · SEC EDGAR · ChEMBL · Wikidata · full sourcing