Dan Song, Wei-Ping Gong, Gui-Lin Xiao

Department of Dermatology, Zhoushan Hospital, Zhoushan City, Zhejiang Province, 316000, People’s Republic of China

Correspondence: Dan Song, Department of Dermatology, Zhoushan Hospital, No. 739, Dingshen Road, Zhoushan City, Zhejiang Province, 316000, People’s Republic of China, Email SongDan127@163.com

Background: This study compares the efficacy and safety of Abrocitinib, a Janus kinase 1 (JAK1) inhibitor, and Dupilumab, an interleukin-4 and interleukin-13 inhibitor, in the treatment of Atopic dermatitis (AD).
Methods: A retrospective study was conducted on 136 patients with moderate to severe AD, treated with either Abrocitinib (n=60) or Dupilumab (n=76) from June 2022 to June 2024. Abrocitinib was administered at 100 mg/day orally, and Dupilumab at 300 mg subcutaneously every two weeks after a 600 mg loading dose. Primary outcome measures included serum immunoglobulin E (IgE) levels, eosinophil (Egb) counts, and clinical symptom improvement, assessed by the Eczema Area and Severity Index (EASI), Numeric Rating Scale (NRS) for pruritus, and Scoring Atopic Dermatitis (SCORAD). Quality of life was evaluated using the Dermatology Life Quality Index (DLQI), while emotional distress was assessed through the Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS). The incidence of adverse reactions was also recorded. Statistical significance was determined using t-tests and Chi-square tests (p < 0.05).
Results: Both treatments reduced IgE and eosinophil levels with no significant inter-group differences (p > 0.05). Abrocitinib was more effective in reducing pruritus, with a greater reduction in NRS scores (p < 0.05). EASI, SCORAD, DLQI, SAS and SDS improvements were similar, though Abrocitinib showed a greater reduction in anxiety (p = 0.011). The overall effective rate was higher in the Abrocitinib group (80.00%) compared to Dupilumab (69.73%) but not significantly (p = 0.174). Adverse reactions were minimal and comparable, with incidences of 8.33% for Abrocitinib and 9.21% for Dupilumab (p = 0.858).
Conclusion: Both Abrocitinib and Dupilumab are effective and well-tolerated treatments for atopic dermatitis. While their overall efficacy and safety profiles are comparable, Abrocitinib offers superior relief of pruritus. Both therapies represent valuable options in the management of moderate to severe atopic dermatitis.

Keywords: atopic dermatitis, Abrocitinib, Dupilumab, Janus kinase 1 inhibitor, interleukin-4 inhibitor