When an eczema treatment isn’t doing enough, switching can feel like a gamble. What if your skin flares while you’re in between? For anyone whose eczema isn’t clearing on DUPIXENT (dupilumab), new data on RINVOQ (upadacitinib) offers some reassurance.
As reported by Dermatology Times, an analysis presented at the 2026 Fall Clinical Dermatology Conference in Las Vegas looked at people with moderate-to-severe eczema who didn’t respond well enough to DUPIXENT and then switched to RINVOQ, an oral JAK inhibitor. In the 16 weeks after the switch, none of the patients with available data had a flare of their skin lesions.
What the research shows
The analysis drew on two head-to-head trials, LEVEL UP and HEADS UP, in which RINVOQ outperformed DUPIXENT. It included people who hadn’t reached at least 75 percent improvement on DUPIXENT before switching. Of the 228 people with flare data (201 in LEVEL UP and 27 in HEADS UP), not one had a skin flare. Researchers defined a flare as a jump of at least 6.6 points on EASI, a standard eczema severity score.
Itch flares were uncommon too, affecting 3.6 percent of people in LEVEL UP (5 of 139) and 4.8 percent in HEADS UP (1 of 21). A rise of at least 4 points on a 10-point scale counted as an itch flare, so that part of the analysis only included people whose itch was at 6 or lower when they switched.
In LEVEL UP, everyone who switched started on the 15-mg dose, with the option to move up to 30 mg depending on how their skin responded. Just over half (52.7 percent) stayed on the lower dose the whole time.
Why switching can feel risky
Even a treatment that only partly works can feel hard to give up. The study authors point to the worry about losing “partial disease control” as something that can make switching decisions harder, and they say the findings may help guide those conversations with patients concerned about their skin or itch getting worse.
How the two drugs differ
DUPIXENT is an injectable that blocks the IL-4 receptor, while RINVOQ is a once-daily pill from a different class of drugs called JAK inhibitors. It’s the same medication behind Europe’s new alopecia areata pill.
What to keep in mind
This was a post hoc analysis, meaning researchers went back to data from trials designed to answer a different question. HEADS UP contributed only 28 patients, the skin-flare results only include people who had data at the checkpoints, and safety data wasn’t reported for the people who switched.
If your current eczema treatment has stopped delivering, ask your dermatologist what your options are. These eczema treatment questions dermatologists hear most are a good place to start. Changing course doesn’t necessarily mean losing the ground you’ve gained.
