Research Article: Real-world effectiveness and safety of 200 mg abrocitinib initiation in Chinese adults with moderate-to-severe atopic dermatitis: a retrospective study
Abstract:
Abrocitinib, a Janus kinase (JAK) inhibitor approved for moderate-to-severe atopic dermatitis (AD), has demonstrated efficacy at 100 mg in randomized controlled trials. However, real-world data on 200 mg initiation in Chinese patients remain scarce.
To evaluate the real-world effectiveness and safety of initiating abrocitinib at 200 mg in Chinese adults with moderate-to-severe AD.
This retrospective study included 20 patients with moderate-to-severe AD treated with abrocitinib. Patients were stratified into Group A (n=7, initiated at 200 mg, tapered to 100 mg if EASI-75 or ?4-point PP-NRS reduction was achieved by week 12) and Group B (n=13, initiated at 100 mg, escalated to 200 mg if targets were not met). Primary outcomes included Eczema Area and Severity Index (EASI), Investigator Global Assessment (IGA), Peak Pruritus Numeric Rating Scale (PP-NRS), and Dermatology Life Quality Index (DLQI). Adverse events (AEs) were recorded.
Both groups showed significant reductions in all outcome measures at weeks 4, 12, and 24. Baseline DLQI was significantly higher in Group A (22.0 vs. 18.0, P < 0.001). At week 4, Group A showed superior PP-NRS improvement (P = 0.019). By week 12, Group A achieved significantly higher rates of EASI < 5 (57.14% vs. 0%, P < 0.01) and IGA 0/1 (85.71% vs. 7.69%, P < 0.01). Notably, 50% of patients had failed prior systemic therapies, including 85.7% in Group A, reflecting the refractory nature of the cohort. At week 24, Group A maintained superiority in EASI and PP-NRS (P < 0.05), while EASI-75 response exceeded 90% in both groups. AEs were comparable between groups (71.43% vs. 61.54%), with no serious events.
The 200 mg initiation strategy offers rapid and sustained disease control, particularly for patients with high baseline disease activity and severe quality of life impairment. The 100 mg strategy achieves favorable outcomes by week 24 for those with milder burden. These findings support personalized dosing, though larger prospective studies are warranted to confirm results.
Introduction:
Abrocitinib, a Janus kinase (JAK) inhibitor approved for moderate-to-severe atopic dermatitis (AD), has demonstrated efficacy at 100 mg in randomized controlled trials. However, real-world data on 200 mg initiation in Chinese patients remain scarce.
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