Abstract
Background: Atopic dermatitis (AD) is an immune system-mediated, complex skin disease. Additional treatment options are needed to provide a better and faster clinical response for patients with AD. Objective: Investigate the difference in efficacy for the rapid relief from pruritus in adults with moderate-to-severe AD. Methods: A 12-week prospective, cohort, observational, single-center study was conducted in adults with moderate-to-severe AD. Patients were assigned randomly (in a 1:1:1 ratio) to receive upadacitinib, abrocitinib, or dupilumab. Pruritus is a key symptom of AD, so the primary endpoint was a reduction in the weekly average worst pruritus Numerical Rating Scale (NRS) score by ≥3 points from baseline at week 4. In addition, we analyzed the response rate at each visit for 75% improvement in Eczema Area and Severity Index (EASI75) and validated Investigator's Global Assessment for Atopic Dermatitis 0/1 (vIGA-AD 0/1). Results: Baseline characteristics was balanced among treatment groups, including measures of disease severity. After 4 weeks of treatment, there was a significant increase in the proportion of patients treated with Janus kinase (JAK) inhibitors who experienced a reduction of ≥3 points in the NRS score compared with those receiving dupilumab. After further treatment, JAK inhibitors resulted in a further reduction of NRS in patients, with a higher percentage of patients achieving EASI75 and vIGA 0/1 (particularly upadacitinib). In addition, no additional serious adverse events were observed during the 12-week follow-up period. Conclusions: JAK inhibitors could be considered as effective treatment options for patients with moderate-to-severe AD, particularly upadacitinib, which has shown the greatest efficacy in reducing itching with a favorable safety profile.
Publication types
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Randomized Controlled Trial
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Observational Study
MeSH terms
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Adult
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Antibodies, Monoclonal, Humanized*
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China
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Dermatitis, Atopic* / diagnosis
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Dermatitis, Atopic* / drug therapy
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Double-Blind Method
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Heterocyclic Compounds, 3-Ring*
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Humans
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Janus Kinase Inhibitors* / adverse effects
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Prospective Studies
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Pruritus / drug therapy
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Pruritus / etiology
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Pyrimidines*
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Severity of Illness Index
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Sulfonamides*
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Treatment Outcome
Substances
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dupilumab
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abrocitinib
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upadacitinib
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Janus Kinase Inhibitors
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Heterocyclic Compounds, 3-Ring
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Pyrimidines
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Sulfonamides
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Antibodies, Monoclonal, Humanized