Cardiovascular Risk and Upadacitinib Treatment for Atopic Dermatitis, With Christopher Bunick, MD, PhD

New findings suggest patients with moderate-to-severe atopic dermatitis treated with upadacitinib for up to 6 years have low rates of major adverse cardiovascular events (MACE), venous thromboembolism (VTE), and malignancy excluding nonmelanoma skin cancer (exNMSC), compared to other patients with this condition and regardless of previous cardiovascular risk status.1,2

These findings, highlighting 2683 upadacitinib-treated patients, were presented as late-breaking data at the European Academy of Dermatology and Venereology (EADV) 2025 Congress in Paris by Christopher G. Bunick, MD, PhD, from the Yale School of Medicine. Bunick spoke with HCPLive during EADV about the findings and their significance.

“These patients in the trials of upadacitinib…Measure Up 1, Measure Up 2, and AD Up, had a lot of comorbid cardiovascular conditions,” Bunick explained. “This included hypertension, diabetes, history of smoking, [oral contraceptive pill] use in women…these types of factors. And what we're trying to understand is how these different factors actually impact the treatment of the atopic dermatitis patient with a JAK inhibitor like upadacitinib.”

In Bunick’s study, highlighted by HCPLive in a previous article, long-term incidence rates remained ≤0.2 per 100 patient-years for MACE and VTE and ≤0.7 per 100 patient-years for exNMSC in the new analysis. These rates were shown to be consistent with background rates in a US atopic dermatitis population of 50,447 patients and did not differ meaningfully by cardiovascular (CV) risk status.

“This provides context to the event rates from the upadacitinib clinical trials, and it makes it, in my opinion, very meaningful when the rates of MACE, VTE, and malignancy are actually lower than what we found in this baseline incidence real-world population comparator arm,” Bunick said. “The cardiovascular risk factors that were accounted for were prior cardiovascular event, hypertension, diabetes, tobacco or nicotine use…And again, the punchline is the upadacitinib was incredibly safe and actually had lower rates compared to the baseline population.”

For any additional information on upadacitinib’s new findings, view our latest coverage of EADV.

Bunick has reported receiving consultant fees or serving as an investigator for AbbVie, Incyte, LEO Pharma and Pfizer.

References

1. Bunick C, Stein Gold L, Silverberg J, et al. Patients with Cardiovascular Risk Factors and Atopic Dermatitis: Long-Term Safety of Upadacitinib for Major Adverse Cardiovascular Events, Venous Thromboembolism, or Malignancy (Excluding Nonmelanoma Skin Cancer). Presented at the 2025 European Academy of Dermatology and Venereology (EADV) Congress, Sept 17-20, 2025.

2. Smith T. Cardiovascular Safety Observed in Upadacitinib Over 6 Years for Atopic Dermatitis. HCPLive. September 19, 2025. https://www.hcplive.com/view/cardiovascular-safety-observed-upadacitinib-over-6-years-atopic-dermatitis.