Significance of Cardiovascular Data on Upadacitinib for Atopic Dermatitis, With Christopher Bunick, MD, PhD

During the European Academy of Dermatology and Venereology (EADV) 2025 Congress in Paris, new data were presented highlighting that those with moderate-to-severe atopic dermatitis on upadacitinib for up to 6 years have low rates of venous thromboembolism (VTE), major adverse cardiovascular events (MACE), and malignancy excluding non-melanoma skin cancer (exNMSC), versus others with this condition and regardless of previous cardiovascular risk status.1,2

These data were presented at EADV by Christopher Bunick, MD, PhD, associate professor of dermatology at Yale School of Medicine, who spoke in a recent interview with HCPLive’s editorial staff about his team’s findings.2 In this interview segment, Bunick’s conversation continued, with the significance of these findings on upadacitinib being the main topic of discussion.

“When we dive deep into this data, there are kind of three big concepts that are buried in this study,” Bunick explained. “First, we have background incident rates of the [atopic dermatitis] population for MACE, VTE, and malignancy, and that is approximately 0.6 events per 100 patient years for MACE, 0.3 events per 100 patient years for VTE, and 1.9 events per 100 patient years for malignancy. That's from our background incidence, real-world cohort, comparing those rates to upadacitinib, whether it's the 15 or 30 milligram dose. What we found was, again, consistent with all prior data safety analyses and other real-world studies, is that the upadacitinib event rates for MACE, VTE, and malignancy are all lower than the background rates in this real-world cohort, baseline population.”

Bunick highlighted additional key parts of this study that he hoped to stress for clinicians learning about these findings for the first time.

“The second key part of this study was to say…we see that upadacitinib’s event rate adverse event rates for MACE, VTE, and malignancy are lower than the background population,” Bunick said. “But what if we now stratify those rates based on zero or greater than or equal to one cardiovascular risk factor? The third key point in this data is the fact that there is no dose-dependent increase in the adverse events of MACE, VTE, or malignancy…Buried within this cardiovascular stratification, again, was the safety [finding] that there was really no difference. But it also was not dose-dependent, so that was a key part of this.”

Bunick noted that clinicians require strong safety data and that patients often search for doctors who are confident in their prescription for medications such as upadacitinib.

For any additional information on late-breaking data in dermatology, view the 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. Bunick C. Cardiovascular Risk and Upadacitinib Treatment for Atopic Dermatitis, With Christopher Bunick, MD, PhD. HCPLive. September 19, 2025. Accessed September 20, 2025. https://www.hcplive.com/view/cardiovascular-risk-upadacitinib-treatment-atopic-dermatitis-christopher-bunick-md-phd.