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Early Clinical Response Predicts Treatment Persistence in Advanced Therapy-naive Atopic Dermatitis
José Javier Martínez-Simón1, Lucía Carrasco-Piernavieja2, Estefanía Zhan Zhou3
1Hospital Pharmacy Department, Hospital Universitario Fundación Alcorcón, Alcorcón, Madrid, Spain. jmsimon@salud.madrid.org.
Acta Dermato-Venereologica
|August 4, 2026
Summary
Treatment persistence in moderate-to-severe atopic dermatitis (AD) varies by therapy. Early response at 16 weeks strongly predicts continued treatment, guiding clinical decisions for advanced therapies like dupilumab and JAK inhibitors.
Area of Science:
- Dermatology
- Pharmacology
- Real-world evidence studies
Background:
- Treatment persistence is crucial for managing moderate-to-severe atopic dermatitis (AD), reflecting both effectiveness and tolerability.
- Advanced therapies including anti-IL-13 agents and JAK inhibitors offer new options for AD patients.
- Understanding factors influencing persistence is key for optimizing treatment strategies.
Purpose of the Study:
- To evaluate treatment persistence rates across different advanced therapies for moderate-to-severe atopic dermatitis.
- To identify predictors of treatment discontinuation in patients initiating dupilumab, anti-IL-13 agents, or JAK inhibitors.
- To determine if early clinical response can predict long-term treatment persistence.
Main Methods:
- Retrospective multicentre cohort study of 146 therapy-naïve moderate-to-severe AD patients.
- Analysis of treatment persistence at 6, 12, 18, and 24 months for dupilumab, anti-IL-13 agents, and JAK inhibitors.
- Multivariable Cox regression used to identify predictors of discontinuation, including early clinical response (EASI, NRS) and patient demographics.
Main Results:
- Overall persistence rates at 24 months were 54.5%, with significant differences between therapeutic groups (log-rank p=0.025).
- JAK inhibitors showed a higher discontinuation risk (HR 1.79) compared to dupilumab; male sex also increased discontinuation risk (HR 2.20).
- Early clinical response at week 16 (EASI improvement and NRS pruritus) was the strongest predictor of persistence, with each 1% EASI increase reducing discontinuation risk by 3% (HR 0.97).
Conclusions:
- Treatment persistence varies significantly among advanced therapies for moderate-to-severe AD.
- Early clinical response at 16 weeks is a strong predictor of treatment persistence, applicable to both objective and patient-reported measures.
- Week 16 serves as a meaningful decision point for response-guided treatment evaluation in routine clinical practice.