Atopic dermatitis is a chronic immune-inflammatory skin disease that significantly impairs quality of life, with itch representing a key, but not exclusive, contributor to this burden. We aimed to evaluate itch relief and quality-of-life improvements with abrocitinib or dupilumab for 16 weeks alongside topical therapy in patients with moderate-to-severe atopic dermatitis. This post hoc analysis included pooled data from patients who received abrocitinib (200 mg/day) or dupilumab (300 mg/every 2 weeks) in phase III JADE COMPARE and JADE DARE. Assessments included proportions of patients achieving a ≥ 4-point improvement from baseline in Peak Pruritus Numerical Rating Scale (PP-NRS4), itch-free state (PP-NRS 0/1) by baseline itch severity, and proportions of patients with residual itch achieving Dermatology Life Quality Index score of 0/1 (DLQI 0/1), total Patient-Oriented Eczema Measure (POEM) score ≤ 2, SCORing Atopic Dermatitis (SCORAD) sleep loss visual analog scale score of 0/1 (SCORAD sleep loss visual analog scale 0/1), and POEM sleep item score of 0 (POEM sleep 0). Among 1196 patients (abrocitinib, n = 588; dupilumab, n = 608), those with greater baseline itch severity experienced greater atopic dermatitis severity and worse quality of life than patients with less severe itch. At week 16, numerically more patients achieved PP-NRS4 (67
Zasocitinib (TAK-279) is an investigational, once daily, oral, allosteric, highly selective, and potent tyrosine kinase 2 inhibitor. Post hoc analyses of a 12-week phase IIb trial in patients with moderate-to-severe plaque psoriasis evaluated zasocitinib 15 mg or 30 mg efficacy versus placebo by baseline characteristic subgroups, Psoriasis Area and Severity Index (PASI) improvements by body region and component scores, and patient-reported and other clinical outcomes. Disease severity assessments included PASI, Physician’s Global Assessment (PGA), body surface area (BSA), Dermatology Life Quality Index (DLQI) 0/1, and PGA × BSA. Subgroups included weight, sex, age, race, disease duration, prior biologic use, and PASI score. Body regions included head, trunk, and upper and lower extremities. Scoring components included erythema, induration, and desquamation. DLQI 0/1 attainment was assessed by PASI. At week 12, zasocitinib 15 mg or 30 mg demonstrated greater response rates in PASI 75/90/100 and PGA 0/1 in nearly all patient subgroups versus placebo. A greater proportion of patients receiving zasocitinib achieved PASI 75/90/100 across all PASI body regions and scoring components versus placebo. Reductions in BSA or PASI were greater in zasocitinib groups as early as week 2 and through week 12 versus placebo; most patients attaining PASI ≤ 1 or ≤ 2 or PASI 75/90/100 also achieved DLQI 0/1. Absolute PASI and PGA × BSA improvements were strongly positively correlated (ρ = 0.95), with PGA × BSA 75 and PASI 75 showing high agreement. Zasocitinib demonstrated consistent improvements in skin clearance, irrespective of baseline disease characteristics, PASI body region, and scoring component, with meaningful quality of life improvements. Graphical abstract available for this article. ClinicalTrials.gov Identifier: NCT04999839.
Atopic dermatitis (AD) is a chronic inflammatory skin disease with significant morbidity. Recognising the need for region-specific guidance, the Skin Allergy Research Society and Society for Eczema Studies have collaborated to develop updated, evidence-based guidelines tailored to the Indian context. These guidelines address AD management across all age groups, special populations while considering local epidemiology, healthcare infrastructure, and treatment accessibility. A structured Delphi consensus process was conducted among 23 dermatology experts over 3 months through virtual and in-person meetings. Literature from MEDLINE, Cochrane, and Google Scholar was systematically reviewed, and the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) approach was used to assess evidence quality. Clinical recommendations were refined through multiple voting rounds, leading to consensus statements. Recommendations are based on an extensive literature review up to December 2024. This document updates the 2019 Skin Allergy Society guidelines, reinforcing global recommendations while allowing local adaptability. These guidelines provide updated recommendations for topical, systemic, phototherapy, and biologic therapies in AD. Key advancements include the introduction of topical crisaborole and JAK inhibitors for mild to moderate AD, along with a focus on emerging systemic therapies, such as biologics and systemic JAK inhibitors. In the Indian context, the guidelines define the roles of dupilumab and abrocitinib while also addressing the off-label use of tofacitinib and baricitinib in resource-limited settings. Specific recommendations are provided for children, elderly patients, and pregnant women, emphasising safety considerations for systemic and biologic therapies. These guidelines align with global AD management while incorporating India-specific adaptations based on epidemiology, accessibility, and affordability. They serve as a key reference for dermatologists, pediatricians, and general practitioners in India and other resource-limited settings. Though tailored for India, they are also relevant to dermatologists in developing countries, guiding treatment selection based on disease patterns, environmental factors, and medication availability.
