Real-world effectiveness of abrocitinib and upadacitinib in atopic dermatitis: a propensity-matched analysis

Objective This study aims to compare the real-world efficacy of abrocitinib versus upadacitinib in patients with atopic dermatitis (AD).Methods We conducted a retrospective analysis of multicenter data from the CORNERSTONE database. Patients with AD treated with abrocitinib or upadacitinib were included. Propensity score matching (PSM) was performed to balance baseline characteristics between groups.Results After PSM, 282 patients were included in each cohort for outcome comparisons. No between-group differences in EASI-75 and EASI-90 responses were observed from week 2 through week 12. The proportion of patients achieving PP-NRS4 response was higher in the upadacitinib group than in the abrocitinib group at week 2 (p < 0.001). When stratified by body sites, the two medications showed comparable efficacy in skin lesion clearance across all body sites. However, patients receiving upadacitinib and abrocitinib exhibited lower EASI-75 response rates in the head and neck region than in other body regions at week 12.Conclusion This study demonstrated that upadacitinib provided greater pruritus relief at early treatment phase compared with abrocitinib in AD patients. Additionally, selective JAK inhibitors showed a lower response rate in the head and neck region than in other body regions.