TOPLINE:

In patients with moderate-to-severe atopic dermatitis, JAK inhibitors (upadacitinib, abrocitinib, and baricitinib) demonstrated sustained improvements in the Eczema Area and Severity Index (EASI), itch, and quality of life at weeks 16 and 24, regardless of prior dupilumab response.

METHODOLOGY:

• Researchers conducted a multicentric real-world retrospective study of 241 patients across 11 dermatologic centres in the Czech Republic between January 2022 and September 2024.
• Participants with moderate-to-severe atopic dermatitis who completed at least 16 weeks of JAK inhibitor therapy were divided into two subgroups on the basis of their current therapy: dupilumab-naive and dupilumab non-responder groups.
• The analysis included EASI, Dermatology Life Quality Index (DLQI), and Itch Numeric Rating Scale changes from baseline at weeks 16 and 24.
• Overall, 148 patients were on upadacitinib (99 dupilumab naive and 49 post-dupilumab failure), 47 were on baricitinib (32 dupilumab naive and 15 post-dupilumab failure), and 46 were on abrocitinib (35 dupilumab naive and 11 post-dupilumab failure).

TAKEAWAY:

• At week 16, EASI-75 response rates among dupilumab-naive vs dupilumab non-responder patients were 86% vs 82% for upadacitinib, 91% vs 73% for abrocitinib, and 81% vs 67% for baricitinib.
• A ≥ 4-point reduction in the Itch Numeric Rating Scale score was achieved by 82% of dupilumab-naive vs 76% of dupilumab non-responder patients on upadacitinib, 83% vs 91% on abrocitinib, and 72% vs 40% on baricitinib.
• At week 16, a ≥ 4-point reduction in DLQI scores occurred in 89% of dupilumab-naive vs 98% of dupilumab non-responder patients on upadacitinib, 97% vs 100% on abrocitinib, and 88% vs 93% on baricitinib. Clinical benefits persisted through week 24, with mean EASI scores remaining below 5 (except baricitinib) and sustained improvements in the DLQI and itch.
• Adverse events occurred in 31.8% of patients on upadacitinib, 41.3% of those on abrocitinib, and 17.0% of those on baricitinib during the first 16 weeks.
• The most common adverse events included acne (9.5%) and hyperlipidaemia (6.1%) for upadacitinib, hyperlipidaemia (15.2%) and herpes simplex infection (8.7%) for abrocitinib, and hyperlipidaemia (10.6%) and upper respiratory tract infections (6.4%) for baricitinib.

IN PRACTICE:

"In conclusion, our retrospective analysis suggests that previous dupilumab failure did not significantly affect the short-term effectiveness of JAK inhibitor therapy for AD [atopic dermatitis]," the authors of the study wrote.

SOURCE:

This study was led by Filip Rob, Department of Dermatovenerology, Second Faculty of Medicine, Bulovka University Hospital, Charles University, Prague, Czech Republic. It was published online on September 21, 2025, in Dermatologic Therapy.

LIMITATIONS:

This study had several limitations, including the small number of patients for abrocitinib and baricitinib groups. Additionally, patients might have used variable in-label doses and adjusted dosages as needed during the study period. The analysis excluded patients lost to follow-up after starting JAK inhibitor treatment, which could have been due to ineffectiveness or adverse events.

DISCLOSURES:

This study did not receive any specific funding. Rob reported receiving honoraria as a speaker, investigator, and/or consultant for AbbVie, Almirall, Amgen, BMS, Eli Lilly, Janssen, Leo Pharma, MSD, Novartis, Pfizer, Sanofi Genzyme, and UCB. Full disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.