Safety and Efficacy of Upadacitinib in Combination With Topical Corticosteroids in Children From 2 to Less Than 12 Years of Age in Japan With Moderate to Severe Atopic Dermatitis (Start Up Japan)

February 20, 2026 updated by: AbbVie

A Phase 3, Randomized, Placebo-Controlled, Double-Blind Study to Evaluate the Safety and Efficacy of Upadacitinib in Combination With Topical Corticosteroids in Children From 2 to Less Than 12 Years of Age in Japan With Moderate to Severe Atopic Dermatitis

Pediatric atopic dermatitis (AD), also known as childhood eczema, is a skin condition that may cause a rash and itching due to inflammation of the skin. The purpose of this study is to assess the change in disease activity (Efficacy) and to assess the safety of upadacitinib in combination with topical corticosteroids (TCS) in pediatric participants 2 to 11 years of age in Japan with moderate to severe AD who are candidates for systemic therapy.

Upadacitinib is approved for the treatment of moderate to severe AD in adults and adolescents 12 years of age and older in many countries, including Japan. This study comprises a 35-day screening period; a 12-week, randomized, double-blind treatment period where there will be a 1 in 2 chance that a participant is assigned placebo. This will be followed by an open-label upadacitinib treatment period up to Week 52.

Around 98 participants will be enrolled in the study at approximately 35 sites in Japan.

Participants will receive upadacitinib oral tablets, or matching placebo, once daily (or an adult equivalent oral solution dose twice a day) for up to 52 weeks.

There may be higher treatment burden for participants in this trial compared to their standard of care . Participants will attend regular visits during the study at a hospital or clinic. The effect of the treatment will be checked by clinical assessments, blood tests, checking for side effects and completing questionnaires.

Study Overview

Status

Active, not recruiting

Conditions

Intervention / Treatment

Study Type

Interventional

Enrollment (Actual)

99

Phase

  • Phase 3

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Contact

Study Locations

      • Saitama, Japan, 336-8522
        • Saitama City Hospital /ID# 271392
    • Aichi-ken
      • Nagoya, Aichi-ken, Japan, 464-0821
        • Central Clinic - Nagoya /ID# 269205
      • Toyoake, Aichi-ken, Japan, 470-1192
        • Fujita Health University Hospital /ID# 269201
    • Chiba
      • Matsudo-Shi, Chiba, Japan, 271-0092
        • Miyata Dermatology Clinic /ID# 269200
    • Fukuoka
      • Fukuoka, Fukuoka, Japan, 814-0171
        • Hoshikuma Dermatology ・ Allergy Clinic /ID# 270192
      • Fukuoka, Fukuoka, Japan, 819-0042
        • Saruta Dermatology Clinic /ID# 270416
      • Kasuga-shi, Fukuoka, Japan, 816-0813
        • Tokunaga Skin Clinic /ID# 270189
      • Kitakyushu-shi, Fukuoka, Japan, 807-8556
        • Hospital Of The University Of Occupational And Environmental Health, Japan /ID# 269206
    • Gunma
      • Maebashi, Gunma, Japan, 371-8511
        • Gunma University Hospital /ID# 272319
    • Hokkaido
      • Sapporo, Hokkaido, Japan, 003-0026
        • Sapporo Shiroishi Dermatology Clinic /ID# 269691
    • Hyōgo
      • Kobe, Hyōgo, Japan, 653-0836
        • Hirase Allergie Children's Clinic /ID# 271208
    • Ibaraki
      • Tsukuba, Ibaraki, Japan, 305-0008
        • Ryuseidai Children's Clinic /ID# 271400
      • Tsukuba, Ibaraki, Japan, 305-8576
        • University of Tsukuba Hospital /ID# 271238
    • Kagawa-ken
      • Marugame, Kagawa-ken, Japan, 763-0074
        • Takeoka Dermatology Clinic /ID# 269199
    • Kanagawa
      • Kawasaki-shi, Kanagawa, Japan, 211-0004
        • Musashikosugi Sasamoto Pediatric And Allergy Clinic /ID# 270381
      • Sagamihara, Kanagawa, Japan, 252-0315
        • National Hospital Organization Sagamihara National Hospital /ID# 271575
    • Kumamoto
      • Kamimashiki-gun, Kumamoto, Japan, 861-2236
        • Aoi Dermatology Clinic /ID# 274265
    • Osaka
      • Higashinari-ku, Osaka, Japan, 537-0013
        • Hayami Dermatology Clinic /ID# 269945
      • Neyagawa, Osaka, Japan, 572-0838
        • Medical corporation Kojinkai Yoshioka Dermatology Clinic /ID# 269198
      • Osaka, Osaka, Japan, 543-0033
        • Momodani Skin Clinic /ID# 270384
      • Osaka, Osaka, Japan, 558-0003
        • Jun Dermatology Clinic /ID# 269953
      • Sakai-shi, Osaka, Japan, 593-8324
        • Dermatology and Ophthalmology Kume Clinic /ID# 271854
    • Tochigi
      • Mibu, Tochigi, Japan, 321-0293
        • Dokkyo Medical University Hospital /ID# 270367
    • Tokyo
      • Chuo-ku, Tokyo, Japan, 103-0031
        • Fukuwa Clinic /ID# 269203
      • Setagaya-ku, Tokyo, Japan, 157-0066
        • Seijo Sasamoto Pediatric Allergy Clinic /ID# 270194

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

  • Child

Accepts Healthy Volunteers

No

Description

Inclusion Criteria:

  • A minimum weight of 10 kg and weight and height ≥ -2.0 SD for their age according to Japanese standard growth charts at the Baseline visit.
  • Atopic Dermatitis (AD), according to Hanifin and Rajka criteria, with onset of symptoms at least 6 months prior to Baseline.
  • Eczema Area and Severity Index (EASI) score ≥ 16; validated Investigator Global Assessment scale for Atopic Dermatitis (vIGA-AD) score ≥ 3; ≥ 10% body surface area (BSA) of AD involvement at the Baseline visit; and Baseline weekly average of daily WIS or WSI-NRS ≥ 4.
  • Participant has applied a topical, additive-free, bland emollient or moisturizer twice daily for at least 7 days before the Baseline visit.
  • Documented history (within 6 months of the Baseline visit) of inadequate response or intolerance to topical corticosteroids (TCS) and/or topical calcineurin inhibitors (TCI) or a systemic immunomodulating therapy, or medical inadvisability of available systemic therapy (e.g., because of important side effects or safety risks).

Exclusion Criteria:

  • Participants that have current and/or history of other active skin diseases (e.g., psoriasis or Netherton syndrome or lupus erythematosus) or skin infections (bacterial, fungal, or viral) requiring systemic treatment within 4 weeks of the Baseline visit or that would interfere with the appropriate assessment of AD lesions.
  • Participants that have used topical treatments for AD (except for topical emollient or moisturizer treatments) including but not limited to TCS, TCI, or topical PDE-4 inhibitors, within 7 days of the Baseline visit or any the following prohibited AD treatments within the specified timeframes below prior to the Baseline visit:

    • Systemic therapy for AD, including but not limited to corticosteroids and cyclosporine, within 4 weeks;
    • Targeted biologic treatments within 5 half-lives (if known) or within 12 weeks, whichever is longer;
    • Phototherapy treatment, laser therapy, tanning booth use, or extended sun exposure that could affect disease severity or interfere with disease assessments within 4 weeks.

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Primary Purpose: Treatment
  • Allocation: Randomized
  • Interventional Model: Parallel Assignment
  • Masking: Triple

Arms and Interventions

Participant Group / Arm
Intervention / Treatment
Placebo Comparator: Placebo / Upadacitinib + Topical Corticosteroids (TCS)
Participants will receive placebo orally once a day (QD) in combination with TCS for 12 weeks in the double-blind treatment period. At Week 12 participants will then be switched to receive open-label upadacitinib daily adult equivalent dose in combination with TCS.
Tablets taken orally once a day (Or equivalent oral solution taken two times a day)
Other Names:
  • ABT-494
  • RINVOQ®
Tablets taken orally once a day (Or equivalent oral solution taken two times a day)
Other Names:
  • ABT-494
  • RINVOQ®
Experimental: Upadacitinib + Topical Corticosteroids (TCS)
Participants will be randomized to receive the upadacitinib daily adult equivalent dose in combination with TCS once a day (QD) during the double-blind and open label treatment periods for a total of 52 weeks
Tablets taken orally once a day (Or equivalent oral solution taken two times a day)
Other Names:
  • ABT-494
  • RINVOQ®

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percentage of Participants Achieving Eczema Area and Severity Index (EASI) 75
Time Frame: At Week 12

EASI is a tool used to measure the extent (area) and severity of atopic eczema based on assessments of the head/neck, trunk, upper limbs and lower limbs. For each region the area score is recorded as the percentage of skin affected by eczema. For each region, the severity score is calculated as the sum of the intensity scores (scored as none [0], mild [1],

An EASI 75 response is defined as a 75% reduction (improvement) from Baseline in EASI score.

At Week 12
Number of Participants With Adverse Events
Time Frame: From first dose of study drug until 30 days following last dose of study drug (up to approximately 56 weeks)
An adverse event (AE) is defined as any untoward medical occurrence in a patient or clinical investigation participant administered a pharmaceutical product and which does not necessarily have a causal relationship with this treatment. An AE can therefore be any unfavorable and unintended sign (including an abnormal laboratory finding), symptom, or disease temporally associated with the use of a medicinal (investigational) product, whether or not the event is considered causally related to the use of the product.
From first dose of study drug until 30 days following last dose of study drug (up to approximately 56 weeks)

Secondary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Percentage of participants achieving validated Investigator Global Assessment scale for Atopic Dermatitis (vIGA-AD) 0/1 with a reduction from Baseline of ≥ 2 points
Time Frame: 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.
At Week 12
Percentage of participants achieving an improved (reduced) weekly average Worst Itch Scale (WIS) score of ≥ 4 from Baseline for participants equal or greater than 6 years old with a weekly average WIS of ≥ 4 at Baseline
Time Frame: At Week 12
The WIS is an assessment tool that participants use to report the intensity of their pruritus. Using an 11-point scale (0 to 10) where 0 indicates no itching and 10 indicates worst itching possible, participants are asked 2 questions: "What was the worst itch you had today?" and "What was the worst itch you had last night?" The WIS will be administered to participants ≥ 6 years of age at the time of the Baseline visit.
At Week 12
Percentage of participants achieving an improved (reduced) weekly average Worst Scratch/Itch numerical rating scale (WIS-NRS) score of ≥ 4 from Baseline for participants less than 6 years old with a weekly average WIS of ≥ 4 at Baseline
Time Frame: At Week 12
The WSI-NRS is an assessment tool that evaluates a participants scratching and itching intensity at its worst in the past 24 hours as assessed by the participants parent/legally authorized representative. Intensity is assessed on an 11-point scale (0 to 10) where 0 indicates no scratching/itching and 10 indicates worst scratching/itching possible.
At Week 12

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Investigators

  • Study Director: ABBVIE INC., AbbVie

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

Helpful Links

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

December 22, 2024

Primary Completion (Estimated)

January 1, 2027

Study Completion (Estimated)

January 1, 2027

Study Registration Dates

First Submitted

November 21, 2024

First Submitted That Met QC Criteria

November 21, 2024

First Posted (Actual)

November 22, 2024

Study Record Updates

Last Update Posted (Actual)

February 23, 2026

Last Update Submitted That Met QC Criteria

February 20, 2026

Last Verified

February 1, 2026

More Information

Terms related to this study

Keywords

Other Study ID Numbers

  • M25-145

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

YES

IPD Plan Description

AbbVie is committed to responsible clinical trial data sharing. This includes access to anonymized, individual and trial-level data (analysis data sets), as well as other information.

IPD Sharing Time Frame

For details on when studies are available for sharing, visit https://vivli.org/ourmember/abbvie/

IPD Sharing Access Criteria

To learn more about the process, or to submit a request, visit the following link https://www.abbvieclinicaltrials.com/hcp/data-sharing/

IPD Sharing Supporting Information Type

  • STUDY_PROTOCOL
  • SAP

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

Yes

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

Yes

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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