Minimal Disease Activity as a Therapeutic Goal in Atopic Dermatitis: Predictive Factors of Sustainability in a...

Minimal disease activity (MDA) is an emerging therapeutic goal in atopic dermatitis (AD), providing a multidimensional assessment of disease control.

We conducted a retrospective multicenter study of adults with moderate-to-severe AD receiving biologics or JAK inhibitors. MDA was defined as Eczema Area and Severity Index (EASI) ≤ 3 and Pruritus Numerical Rating Scale (NRS) ≤ 1. Univariate analyses were performed to identify baseline predictors of sustained MDA at week 52 among patients who had previously achieved MDA at week 16.

Among 197 patients with week 16 data, 107 (54.3%) achieved MDA. Of these, 59 had data at week 52, and 51 (86.4%) maintained MDA in a per-protocol analysis among patients with available follow-up. Sustained MDA was associated with the absence of hand involvement and fewer prior conventional treatments. No significant differences were found in gender, body mass index (BMI), baseline EASI score, or years of diagnostic delay. A younger age showed a trend toward a significant association with MDA loss. No statistically significant differences were found in the sustainability of MDA at week 52 between treatment groups (dupilumab, tralokinumab, and upadacitinib).

Sustained MDA among early responders is feasible in real-life AD practice. Baseline characteristics may help identify patients most likely to benefit from early targeted treatment.