Efficacy and Safety of Abrocitinib for Moderate-to-severe Atopic Dermatitis in Adults: A 52-week Real-world Multicentre StudyIL-AD (Italian Landscape Atopic Dermatitis)

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Abstract
Abrocitinib, an oral selective Janus kinase 1 inhibitor, is approved for the treatment of moderate-tosevere atopic dermatitis (AD) in adults, but realworld evidence remains limited. We retrospectively collected data from 187 adult patients (mean age:37.9 years; 60.4% male), with AD and up to oneyear exposure to abrocitinib either 100 or 200 mg, between 2023 and 2025 across 22 Italiandermatology centres. Nearly half of patients were bio-experienced and 80 % had difficult-to-treat areas. Beginning at week 8, with either 100 (59%) or 200 mg, 52 % achieved Investigator Global Assessment 0/1, significantly increasing to 88 % at week 52. Similarly, Eczema Area and Severity Index (EASI) and itch had significantly higher 1-year response: increasing from 27.8% and 34.7%, respectively, at week 8, 79.6 % achieved EASI-90 and 73.5% reached Peak Pruritus-Numerical Rating Scale 0/1. Minimal disease activity, a stringent composite endpoint, was met by 18 % at week 8 and by 66 % at week 52. Safety was good, with mild adverse eventsmostly including abdominal pain, upper respiratory infections and headache. The 100 mg dose had a significantly better safety profile, with efficacy similar to 200 mg. These data confirm the efficacy and safety of abrocitinib, with early, progressive clinical benefitssustained through 1 year.

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