Efficacy of Abrocitinib and Dupilumab in Adults with Moderate-to-Severe Atopic Dermatitis Using Treat-to-Target Goals Recommended by Experts in China

Introduction: An international treat-to-target (T2T) consensus for atopic dermatitis (AD), encompassing clinical and patient-reported outcomes, was proposed in 2021. A revised framework of systemic drug therapy for moderate-to-severe AD was proposed by Zhao and Gao in 2022. This study aimed to evaluate the efficacy of abrocitinib and dupilumab in patients with moderate-to-severe AD in the context of the clinical and patient-reported T2T goals for AD proposed by Zhao and Gao. Methods: Data were evaluated from adults with moderate-to-severe AD who received abrocitinib (200 mg/day) or dupilumab (300 mg biweekly after a 600 mg loading dose) for 16 weeks in JADE COMPARE and 26 weeks in DARE. Data from patients who received abrocitinib 100 mg/day in JADE COMPARE were also included in this analysis. Assessments included the proportions of patients attaining 1-year T2T goals proposed by Zhao and Gao (Peak Pruritus Numerical Rating Scale score of ≤4, ≥75% improvement in Eczema Area and Severity Index EASI or EASI≤7, ≥75% improvement in SCORing Atopic Dermatitis SCORAD or SCORAD≤24, Patient-Oriented Eczema Measure score of ≤7, and Dermatology Life Quality Index score of ≤5 at Week 16 of JADE COMPARE and Week 26 of DARE. Results: In JADE COMPARE, 226, 238, and 242 patients received abrocitinib 200 mg, 100 mg and dupilumab, respectively. In JADE DARE, 362 received abrocitinib 200 mg and 365 received dupilumab. The proportions of patients attaining the 1-year T2T goals at Week 16 of JADE COMPARE were 41.2% (200 mg), 29.5% (100 mg) and 29.0% (dupilumab); these proportions were 49.5% (200 mg) and 38.3% (dupilumab) at Week 26 of DARE. Conclusions: Greater proportions of patients attained the 1-year T2T improvements proposed by Zhao and Gao with abrocitinib 200 mg than with dupilumab. Early achievement of 1-year targets in many patients treated with abrocitinib suggest that target domains may necessitate re-evaluation.