Abstract Abrocitinib, a selective Janus kinase 1 (JAK1) inhibitor, has demonstrated efficacy in moderate-to-severe atopic dermatitis (AD), although data in patients whose AD is resistant to multiple systemic therapies remain limited. We report the case of six patients with moderate-to-severe AD who were unresponsive to previous treatments, including dupilumab, tralokinumab, lebrikizumab, upadacitinib and/or baricitinib. All patients received abrocitinib 200 mg daily. After only 16 weeks, five patients achieved a good clinical response, defined as an Eczema Area Severity Index score of ≤7 and a reduction of ≥3 points in the itch Numerical Rating Scale; in three patients, this response was maintained through 32 weeks. Two patients discontinued abrocitinib due to primary or secondary inefficacy. No serious adverse events were reported; only one patient experienced mild increases in cholesterol and triglyceride levels. These findings suggest that patients with difficult-to-treat AD may benefit from therapy with abrocitinib, potentially due to its high selectivity for JAK1, which may explain its efficacy where other JAK inhibitors have failed.
Ippoliti et al. (Fri,) studied this question.