JAK Inhibitors in Atopic Dermatitis: Does Weight Matter? A Real-World, Nationwide Retrospective Study: IL-AD (Italian Landscape Atopic Dermatitis).

IF 3.5 3区医学 Q1 DERMATOLOGY

Dermatology and Therapy Pub Date : 2025-07-24 DOI:10.1007/s13555-025-01477-0

Mariateresa Rossi, Stefano Bighetti, Alessandra Narcisi, Antonio Costanzo, Matteo Bianco, Piergiorgio Malagoli, Francesco Messina, Francesca Gaiani, Silvia Mariel Ferrucci, Angelo Valerio Marzano, Francesca Barei, Simone Ribero, Michela Ortoncelli, Francesco Leo, Maddalena Napolitano, Andrea Cosenza, Cataldo Patruno, Mario Bruno Guanti, Anna Balato, Francesco Loconsole, Claudio Sciarrone, Federica Veronese, Elena Pezzolo, Anna Graziella Burroni, Massimo Gola, Carlotta Gurioli, Flavia Manzo Margiotta, Maria Letizia Musumeci, Francesca Satolli, Giuseppe Amoruso, Maria Esposito, Caterina Foti, Paolo Pella, Anna Campanati, Andrea Carugno, Nicola Zerbinati, Martina Maurelli, Ilaria Trave, PierGiacomo Calzavara-Pinton, Luca Bettolini

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引用次数: 0

Abstract

Introduction: Janus kinase (JAK) inhibitors are effective systemic treatments for moderate-to-severe atopic dermatitis (AD), rapidly controlling symptoms and improving quality of life. However, the impact of body mass index (BMI) on therapeutic response remains unclear.

Methods: This multicenter retrospective study analyzed data from 388 adult AD patients treated with upadacitinib, abrocitinib, or baricitinib across 25 Italian dermatology centers between May 2022 and July 2024. Patients were classified as overweight (BMI ≥ 25) or non-overweight (BMI < 25), with disease severity assessed using EASI, IGA, and Numerical Rating Scales (NRS) for pruritus and sleep disturbance over 104 weeks. The effect of different treatment dosages was also evaluated.

Results: No significant BMI-related differences in clinical outcomes were noted at most timepoints. However, in the upadacitinib 15 mg group, non-overweight patients showed greater EASI and pruritus improvements at Week 4 (p = 0.037, p = 0.039), although these differences resolved subsequently. At Week 104, higher BMI modestly reduced EASI improvement (p = 0.045) in multivariable analysis.

Conclusions: Treatment dosage consistently influenced clinical improvement regardless of BMI. These findings confirm the efficacy of JAK inhibitors across BMI categories, suggesting minimal short-term BMI influence but highlighting potential long-term considerations in overweight patients, emphasizing personalized dosing strategies and prolonged monitoring.

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JAK抑制剂治疗特应性皮炎：体重重要吗？一项真实世界的全国性回顾性研究：IL-AD（意大利景观特应性皮炎）。

简介：Janus激酶（JAK）抑制剂是中重度特应性皮炎（AD）的有效全身治疗方法，可快速控制症状并改善生活质量。然而，身体质量指数（BMI）对治疗反应的影响尚不清楚。方法：这项多中心回顾性研究分析了2022年5月至2024年7月期间意大利25个皮肤科中心388名接受upadacitinib、abrocitinib或baricitinib治疗的成年AD患者的数据。患者被分为超重（BMI≥25）或非超重（BMI）。结果：在大多数时间点，临床结果没有发现明显的BMI相关差异。然而，在upadacitinib 15 mg组中，非超重患者在第4周表现出更大的EASI和瘙痒改善（p = 0.037, p = 0.039），尽管这些差异随后消退。在多变量分析中，第104周时，较高的BMI适度降低了EASI的改善（p = 0.045）。结论：无论BMI如何，治疗剂量始终影响临床改善。这些发现证实了JAK抑制剂在BMI类别中的有效性，表明短期BMI影响最小，但强调了超重患者潜在的长期考虑，强调个性化给药策略和长期监测。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Dermatology and Therapy Medicine-Dermatology

CiteScore

6.00

自引率

8.80%

发文量

187

审稿时长

6 weeks

期刊介绍： Dermatology and Therapy is an international, open access, peer-reviewed, rapid publication journal (peer review in 2 weeks, published 3–4 weeks from acceptance). The journal is dedicated to the publication of high-quality clinical (all phases), observational, real-world, and health outcomes research around the discovery, development, and use of dermatological therapies. Studies relating to diagnosis, pharmacoeconomics, public health and epidemiology, quality of life, and patient care, management, and education are also encouraged. Areas of focus include, but are not limited to all clinical aspects of dermatology, such as skin pharmacology; skin development and aging; prevention, diagnosis, and management of skin disorders and melanomas; research into dermal structures and pathology; and all areas of aesthetic dermatology, including skin maintenance, dermatological surgery, and lasers. The journal is of interest to a broad audience of pharmaceutical and healthcare professionals and publishes original research, reviews, case reports/case series, trial protocols, and short communications. Dermatology and Therapy will consider all scientifically sound research be it positive, confirmatory or negative data. Submissions are welcomed whether they relate to an International and/or a country-specific audience, something that is crucially important when researchers are trying to target more specific patient populations. This inclusive approach allows the journal to assist in the dissemination of quality research, which may be considered of insufficient interest by other journals. The journal appeals to a global audience and receives submissions from all over the world.