Upadacitinib: Long-Term Safety Profile for Inflammatory Skin Diseases Confirmed

The European Medical Journal (EMJ) reported on March 29, 2026, findings presented at the American Academy of Dermatology (AAD) Annual Meeting 2026 concerning the long-term safety of upadacitinib (marketed as Rinvoq) across various age groups, particularly for patients with moderate-to-severe atopic dermatitis. The AAD 2026 meeting is taking place from March 27-31, 2026, in Denver, Colorado, confirming the timeliness and accuracy of the article's context. Upadacitinib is an oral, selective Janus kinase (JAK) 1 inhibitor that modulates inflammatory pathways involved in several chronic immune-mediated diseases. It has received approval from regulatory bodies like the U.S. Food and Drug Administration (FDA) and the European Medicines Agency (EMA) for conditions such as rheumatoid arthritis, psoriatic arthritis, atopic dermatitis, ulcerative colitis, Crohn's disease, ankylosing spondylitis, non-radiographic axial spondyloarthritis, polyarticular juvenile idiopathic arthritis, and giant cell arteritis. Its global approval makes news regarding its safety highly relevant to an Indian audience, where these inflammatory conditions are prevalent and treatment options are crucial. The EMJ article highlights long-term safety data derived from three Phase III studies: Measure Up 1, Measure Up 2, and AD Up. These studies included both global and U.S. patient populations, with outcomes assessed for up to six years. The analysis involved 2,683 patients who received at least one dose of upadacitinib (15 mg or 30 mg once daily), either as monotherapy or with concomitant topical corticosteroids, totaling over 9,000 patient-years of exposure. The key finding from this analysis is that upadacitinib generally maintains a consistent and low rate of safety events across approved age groups for moderate-to-severe atopic dermatitis. Rates of adverse events of special interest were broadly consistent in patients younger than 65 years. However, the data also indicated relatively higher rates for some adverse events in older adults, specifically those aged 65 years and above, particularly when receiving the higher 30 mg dose. No major cardiovascular adverse events were reported in younger adults (aged 12 to 49 years). A dose-dependent increase in herpes zoster was observed with the 30 mg regimen across all age groups, emphasizing the need for careful dose selection in long-term management. These findings align with existing comprehensive safety reviews and integrated analyses of upadacitinib across its approved indications. For instance, an integrated safety analysis with a data cutoff in August 2024, pooling data from 16 studies with over 27,000 patient-years of exposure, concluded that upadacitinib is well tolerated over long-term follow-up, consistent with its known safety profile. This analysis also noted numerically higher rates of herpes zoster, non-melanoma skin cancer (NMSC), and elevated creatine kinase with upadacitinib compared to active comparators in rheumatoid arthritis and psoriatic arthritis patients. However, rates of major adverse cardiovascular events (MACE), venous thromboembolism (VTE), and malignancy (excluding NMSC) were similar between upadacitinib and active comparators in these indications. Regulatory agencies have issued warnings for JAK inhibitors, including upadacitinib, due to an increased risk of serious infections (such as tuberculosis, invasive fungal, bacterial, and viral infections including herpes zoster), MACE, VTE, malignancies (lymphoma and other cancers), and all-cause mortality, especially in patients aged 50 years or older with at least one cardiovascular risk factor. Gastrointestinal perforations are also identified as a serious, albeit rare, side effect. These risks necessitate thorough patient evaluation and ongoing monitoring during treatment. For the Indian context, the prevalence of tuberculosis is a particularly important consideration, requiring pre-screening and vigilance during therapy. The data presented at AAD 2026 reinforce that while upadacitinib offers a favorable benefit-risk profile for long-term treatment of moderate-to-severe atopic dermatitis, particularly with the 15 mg dose, clinicians must consider individualized patient factors, including age and the presence of comorbidities, when selecting the appropriate dose and monitoring strategy. This long-term data provides reassurance regarding the sustained safety of upadacitinib while also highlighting crucial age- and dose-related considerations for optimized patient care. **VERIFICATION FINDINGS:** 1. **All major claims and facts are verified:** The article reports on long-term safety data of Upadacitinib, presented at the AAD 2026 meeting. This is corroborated by direct search results for the EMJ article itself and multiple other scientific publications discussing Upadacitinib's safety profile over various durations and indications. The AAD 2026 meeting is indeed ongoing during the publication date of the article. 2. **Headline accuracy:** The headline is accurate. The AAD 2026 meeting is current (March 27-31, 2026), and the European Medical Journal published an article with this exact title on March 29, 2026, reporting on data presented there. It is not sensationalized, fake, or inaccurate. 3. **Credible sources:** The European Medical Journal is a credible source. The information is corroborated by numerous peer-reviewed articles and clinical trial data indexed on PubMed, PMC, and other reputable medical and pharmaceutical information portals. 4. **Misinformation or exaggeration:** No misinformation or exaggeration was identified in the headline or the implied content based on corroborating sources. 5. **News category:** Health, Medicine, Pharmaceuticals, Dermatology, Clinical Research, Science. 6. **Country specificity:** Global. The drug and its safety profile have global implications, including for patients in India.

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