ORIGINAL RESEARCH article
Front. Immunol.
Sec. Autoimmune and Autoinflammatory Disorders : Autoimmune Disorders
Volume 16 - 2025 | doi: 10.3389/fimmu.2025.1639932
This article is part of the Research TopicCrosstalk: Skin Cells and Immune Cells in Inflammatory Skin Diseases: Volume 2View all 5 articles
Comparative Short-Term Efficacy of Janus Kinase 1 Inhibitors and Anti-Interleukin-13 Antibodies in Atopic Dermatitis: A Retrospective Cohort Analysis Based on Real-World Data
Provisionally accepted
- Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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Introduction: Molecular targeted therapies, including advanced atopic dermatitis (AD) treatment with Janus kinase 1 inhibitors (JAK1i) and anti-interleukin-13 antibodies (IL-13Ab), are emerging as effective options. However, the predictive biomarkers for treatment responses remain unclear. Therefore, this study compared the short-term efficacy of JAK1i and IL-13Ab and explored relevant biomarkers. Methods: This retrospective analysis was conducted in 75 patients with moderate-to-severe AD treated at Fukuoka University Hospital. Relevant biomarkers, including eosinophil count and thymus and activation-regulated chemokine (TARC) levels, were measured at baseline and 3 months. Eczema Area and Severity Index (EASI) and Peak Pruritus Numerical Rating Scale (PP-NRS) scores were also assessed. Results: Patients received JAK1i (n=37; abrocitinib, n=16; upadacitinib, n=21) or IL-13Ab (n=38; lebrikizumab, n=21; tralokinumab, n=17). At 3 months, no significant difference was observed between JAK1i and IL-13Ab in achieving EASI 75 (odds ratio [OR] = 0.83, p=0.76) or in the incidence of adverse events (OR = 1.40, p=0.55). However, JAK1i was associated with higher odds of achieving PP-NRS 4 (OR=9.36, p=0.0063) and PP-NRS 0/1 (OR=34.61, p<0.0001). In the JAK1i group, eosinophil count reduction correlated with EASI improvement (univariate: R=0.525, p=0.0009; adjusted: β = 0.567, p=0.0004). In the IL-13Ab group, TARC reduction correlated with EASI improvement (univariate: R=0.677, p<0.0001; adjusted: β = 0.661, p<0.0001). Conclusion: JAK1i showed greater antipruritic effects than IL-13Ab at 3 months, likely due to interleukin (IL)-31 inhibition. Eosinophil count reduction was the most reflective biomarker of JAK1i efficacy, potentially due to IL-5 suppression, whereas TARC improvement was significantly associated with patients’ treatment response to IL-13Ab. These findings highlight the need for further long-term studies.
Keywords: Janus kinase 1 inhibitors, anti-IL-13 antibodies, IL-31, Pruritus, IL-5, Eosinophils, TARC, atopic dermatitis
Received: 04 Jun 2025; Accepted: 23 Jul 2025.
Copyright: © 2025 Sato, Obonai, Iwata, Ito and Imafuku. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Emi Sato, Faculty of Medicine, Fukuoka University, Fukuoka, Japan
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