Real-World Evidence for the Impact of Minimal Disease Activity on Quality of Life in Atopic Dermatitis: An Interim Analysis of the Prospective, Multicenter, Non-Interventional UP-TAINED Study

INTRODUCTION: Minimal disease activity (MDA) has recently been introduced as comprehensive treatment target in atopic dermatitis (AD), integrating both clinician- and patient-reported outcomes. Evidence on the real-world feasibility and impact of achieving MDA on quality of life (QoL) remains limited. This analysis evaluated the association between MDA achievement and QoL outcomes in patients with moderate-to-severe AD receiving upadacitinib (UPA) in real-world clinical practice. METHODS: This interim analysis used data from the ongoing, prospective, multicenter, non-interventional UP-TAINED study (NCT05139836) in Germany. Analyses included all patients without treatment interruptions during the first 12 months (n = 259). Disease control was classified as optimal, moderate, or none. Optimal control (MDA) was defined as Eczema Area and Severity Index (EASI) ≤ 3 and Worst Pruritus Numeric Rating Scale (WP-NRS) ≤ 0/1; moderate control as EASI ≤ 3 with WP-NRS 2-3 or EASI > 3-7 with WP-NRS ≤ 3; and no control as EASI > 7 or WP-NRS > 3. QoL outcomes were assessed using validated patient-reported measures. RESULTS: MDA was achieved by 38.2% of patients at month 1 and by 42.1% at month 12. Those achieving MDA reported substantially greater improvements across all QoL measures compared with patients with moderate or no disease control. QoL outcomes were comparable between patients starting UPA at 15 mg or 30 mg. The most frequent adverse events were AD, acne, and corona virus disease 2019 (COVID-19) infection; the safety profile was consistent and no new safety signals were identified. CONCLUSION: Achieving MDA was associated with markedly improved QoL in real-world AD management, supporting MDA as a feasible and clinically meaningful treatment goal in routine practice. TRIAL REGISTRATION: ClinicalTrials.gov Identifier, NCT05139836.