CAN UpTIMISE Data Reveals Improved Outcomes for Dupilumab-Inadequate Responders
NASHVILLE, Tenn. – New real-world evidence presented at the 2025 RAD Conference demonstrates that patients with moderate-to-severe atopic dermatitis (AD) who switch from dupilumab to upadacitinib can achieve significantly better disease control, according to findings from the Canadian CAN UpTIMISE study.
Study Overview
The prospective, multicenter observational study (NCT05394792) evaluated 143 adult AD patients who were inadequate responders to dupilumab or discontinued due to safety/tolerability issues. All participants transitioned to upadacitinib (15mg or 30mg daily) in routine clinical practice.
“These findings support a paradigm shift where dermatologists should aim for higher treatment targets,” said lead investigator Dr. Vimal Prajapati from the University of Calgary. “When patients aren’t achieving adequate responses with dupilumab, switching can provide incremental benefits.”
Key Efficacy Results at Month 4
| Outcome Measure | Response Rate |
|---|---|
| vIGA-AD 0/1 (clear/almost clear) | 65.9% |
| EASI ≤7 | 90.2% |
| EASI ≤3 | 82.9% |
| WP-NRS ≥4 point reduction | 70.5% |
| DLQI ≥4 point improvement | 79.0% |
| Minimal Disease Activity (EASI≤3 + WP-NRS 0/1) | 43.8% |
Safety Findings
- 60% experienced treatment-emergent adverse events (mostly mild/moderate)
- 3 severe events (only 1 possibly drug-related)
- 6 serious adverse events in 3 patients (none deemed drug-related)
- 11 discontinuations (8 considered drug-related)
- No deaths reported
Clinical Implications
The study provides practical guidance for clinicians:
- Switching can benefit patients with suboptimal dupilumab response
- Improvements seen across all efficacy measures, including quality of life
- Safety profile consistent with known JAK inhibitor effects
- Standard baseline monitoring remains essential
Dr. Prajapati emphasized: “While we must monitor for certain adverse events, most are manageable and serious effects are infrequent. The clinical benefits for appropriate patients are substantial.”
Practice Recommendations
For patients considering the switch:
- Complete baseline labs (CBC, liver enzymes, lipids)
- Conduct infectious disease screening (TB, HBV/HCV/HIV)
- Perform pregnancy testing when applicable
- Monitor for clinical response and adverse events
The findings were presented at RAD 2025 and build on growing evidence supporting targeted treatment sequencing in moderate-to-severe AD management.
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