Successful Dose Reduction of Janus-kinase Inhibitors in Well-controlled Atopic Dermatitis: A Prospective,...

Area of Science:

• Dermatology
• Immunology
• Pharmacology

Background:

• Janus kinase 1 (JAK1) inhibitors are effective treatments for atopic dermatitis.
• Adverse events associated with JAK1 inhibitors necessitate strategies to mitigate risks, such as dose reduction.
• Limited real-world data exists on the efficacy and safety of JAK1 inhibitor dose reduction strategies.

Purpose of the Study:

• To investigate the feasibility and outcomes of JAK1 inhibitor dose reduction in adults with controlled atopic dermatitis.
• To assess the proportion of patients maintaining a reduced JAK1 inhibitor dose over 12 weeks.
• To evaluate physician- and patient-reported outcomes during dose reduction.

Main Methods:

• Prospective, real-world study involving 60 adults with controlled atopic dermatitis on abrocitinib or upadacitinib.
• JAK1 inhibitor doses were halved or administered every other day.
• Outcomes including disease activity and patient-reported measures were assessed at baseline and weeks 4, 8, and 12.

Main Results:

• 80% (48/60) of patients successfully maintained a reduced JAK1 inhibitor dose at 12 weeks.
• All assessed outcomes remained within treat-to-target goals, with no clinically meaningful increase in disease activity.
• Patients who resumed their initial dose regained disease control.

Conclusions:

• Dose reduction of JAK1 inhibitors is a feasible strategy for managing atopic dermatitis in a real-world setting.
• This approach can be effective in maintaining disease control while potentially mitigating adverse events.
• Further research can explore long-term outcomes and optimal dose reduction protocols.