Comparative Real-World Effectiveness and Safety of Biologics and JAK Inhibitors in Atopic Dermatitis: Short- and Medium-to-Long-Term Analysis from a Regional Healthcare Network in Southern Spain

Alvaro Prados-Carmona^1,2,3*Francisco José Navarro Triviño^1,2,3Husein Husein-ElAhmed^3,4Ricardo Ruiz-Villaverde^1,3

• ¹Hospital Universitario San Cecilio Servicio de Dermatologia, Granada, Spain
• ²Universidad de Granada, Granada, Spain
• ³Instituto de Investigacion Biosanitaria de Granada, Granada, Spain
• ⁴Hospital General de Baza, Baza, Spain

Background: Biologics and Janus kinase (JAK) inhibitors have expanded treatment options for moderate-to-severe atopic dermatitis (AD), but comparative real-world data are still limited. Objective: To compare disease-related characteristics and outcomes of patients with moderate-to-severe AD treated with biologics or JAK inhibitors in routine clinical practice. Methods: An ambispective, observational study was conducted in three hospitals in southern Spain. Patients initiating advanced systemic therapy (AST) between 2019 and 2024 were included. Baseline disease-related variables, clinical severity scores, treatment outcomes, adverse events and drug survival were assessed. Short (16 weeks) and medium-to-long-term (24 and 52 weeks) intervals were considered. Super-responder rates according to a proposed definition were also evaluated. Results: 202 patients were included (134 biologics, 68 JAK inhibitors). JAK inhibitors showed faster early responses, while biologics led to greater absolute improvements between weeks 16 and 52, with longer treatment persistence. Adverse events profile differed between families: infections and acne were more common with JAKi; ocular symptoms with biologics. Super-responder rate differences were not statistically significant between groups (16.42% vs 23.53%, p = 0.25443). Conclusions: Both drug classes were effective and well tolerated. Differences in response dynamics and safety support individualized treatment decisions.