Efficacy and Safety of Abrocitinib in an Elderly Chinese Population with Moderate-to-Severe Atopic Dermatitis: A Non-randomized Controlled Trial

Abstract

There is a paucity of data regarding the use of Janus kinase inhibitors in elderly patients with moderate-tosevere atopic dermatitis necessitating systemic therapy. This study aimed to evaluate the efficacy and safety of abrocitinib compared with dupilumab in atopic dermatitis patients aged 60 years or older. A single-centre, non-randomized controlled trial (ChiCTR2300077724) was conducted from December 2022 to March 2024, in which 58 patients were assigned to receive either abrocitinib (100 mg daily) or dupilumab (600 mg loading dose followed by 300 mg every 2 weeks). The primary endpoints were the proportion of patients achieving a ≥ 4-point reduction in the Peak Pruritus Numerical Rating Scale (PP-NRS) at Week 2 and the proportion achieving Eczema Area and Severity Index (EASI)-75 at Week 12; EASI-90 response at Week 24 was a key secondary endpoint. Results showed that a higher proportion of patients receiving abrocitinib achieved a PPNRS4 response at Week 2 (52% vs 26%; p = 0.046). At Week 12, EASI-75 response rates were similar between the 2 groups (45% for abrocitinib vs 44% for dupilumab; p = 0.95). By Week 24, the EASI-90 response rate was 52% in the abrocitinib group compared with 41% in the dupilumab group (p = 0.4). Adverse events in the abrocitinib group included colon tumour (3%), nausea (6%), folliculitis (6%), and headache (16%), while the dupilumab group reported T-cell prolymphocytic leukaemia (3%) and conjunctivitis (7%). In conclusion, abrocitinib provided more rapid relief from pruritus and demonstrated superior long-term efficacy compared with dupilumab in the elderly population.