AAD 2025: Key insights on abrocitinib in atopic dermatitis management

Atopic dermatitis (AD) poses a significant disease burden, with effective symptom management remaining a challenge in diverse populations. This article highlights new data on abrocitinib, an oral Janus kinase 1 (JAK1) inhibitor, presented at the 2025 American Academy of Dermatology (AAD) Annual Meeting, including its real-world effectiveness in Chinese patients, clinical findings on sleep improvement, and long-term safety in young adults. 

AHEAD: Real-world evidence in Chinese patients
Despite proven efficacy in treating moderate-to-severe AD in clinical settings, real-world data for abrocitinib, particularly in the Chinese population, was limited. The ongoing observational, prospective, multicentre Chinese AHEAD registry study evaluated the effectiveness of abrocitinib in 314 patients who were either abrocitinib-naïve or had discontinued previous abrocitinib treatment for >30 days at enrolment (mean age, 43.6 years; female, 47.5 percent). Nearly all patients (99.2 percent) had AD for <5 years, and 45.6 percent reported ≥5 AD flares at baseline. [Zhang L, et al, AAD 2025, poster 63262]

The interim analysis revealed treatment patterns in the Chinese population. Among patients with treatment records available, 45.5 percent had received systemic treatments, including traditional treatments and biologics, prior to starting abrocitinib. The initial dose of abrocitinib was 100 mg QD in 92.9 percent of patients, while the rest received 200 mg QD. One-third of patients underwent dose adjustments.

The study also demonstrated notable improvements in multiple clinical outcomes with abrocitinib treatment. At week 12, mean Investigator’s Global Assessment (IGA) score decreased by 40 percent from baseline, with 36.1 percent of patients achieving IGA success. Mean Eczema Area and Severity Index (EASI) score decreased by 79 percent, and 61.6 percent of patients achieved an EASI-75 response. Mean Peak Pruritus Numerical Rating Scale (PP-NRS) score decreased by 52 percent, with 58.2 percent of patients achieving PP-NRS 4 relief and 29.2 percent achieving a PP-NRS 0/1 response. (Figure)

JADE DARE: Improved sleep outcomes
Due to intense pruritus, AD patients often experience sleep disturbances, leading to daytime fatigue, cognitive impairment, and a negative impact on quality of life. In a post hoc analysis of the phase III head-to-head JADE DARE trial (n=727) comparing abrocitinib 200 mg with subcutaneous dupilumab 300 mg Q2W, patients on abrocitinib showed numerically greater improvements in sleep duration as measured by least squares mean (LSM) change from baseline at week 12 (0.7 vs 0.5 hours) and week 26 (0.5 vs 0.4 hours), based on the Medical Outcomes Study-Sleep Scale (MOS-SS) quantity of hours slept. [Lancet 2022;400:273- 282; Allergy 2024;79:26-36; Dermatitis 2022;33:S104-S113; Rice ZP, et al, AAD 2025, poster 62307]

Reductions in sleep disturbance, as measured by LSM change from baseline in MOS-SS sleep disturbance score, were greater with abrocitinib vs dupilumab at week 12 (-20.5 vs -16.4) and week 16 (-21.5 vs -17.7) and remained numerically greater at week 26 (-21.2 vs -19.5). Additionally, patients on abrocitinib achieved greater improvement in Scoring Atopic Dermatitis (SCORAD) visual analog scale (SCORAD-VAS) sleep loss score vs dupilumab as early as week 2 (LSM change from baseline, -3.7 vs -2.6). [Rice ZP, et al, AAD 2025, poster 62307]

Compared with dupilumab, abrocitinib demonstrated more rapid and numerically greater improvements in all sleep- and pruritus-related endpoints at all other timepoints.

Long-term safety in young adults
Expanding on the previously established safety profile in adults and adolescents, an integrated safety analysis evaluated the long-term safety of abrocitinib in young adults (aged 18–<30 years) with moderate-to-severe AD. The study included data from 490 adolescents (aged 12–<18 years), 1,014 young adults, and 581 adults (aged 30–<40 years) across multiple phase II and III studies, including JADE MOA, JADE MONO-1, JADE MONO-2, JADE COMPARE, JADE TEEN, JADE DARE, and the ongoing JADE EXTEND study. [Simpon EL, et al, AAD 2025, poster 64775]

Results showed a similar incidence of treatment-emergent adverse events (AEs) across age groups (adolescents, 81.2 percent; young adults, 84.7 percent; adults, 83.6 percent). Notably, serious AEs occurred less frequently in young adults (7.6 percent) than in adolescents (9.0 percent) or adults (10.3 percent).

The incidence rates (IRs) of AEs of special interest in young adults were also comparable to other age groups, except for a lower rate of herpes zoster in adolescents. IRs of serious infection were 1.43 per 100 patient-years (PY) in adolescents, 1.90 per 100 PY in young adults, and 2.67 per 100 PY in adults. The results indicated that abrocitinib was well tolerated in young adults treated for up to 4.5 years, with no new safety signals observed compared with adolescents or adults.

Summary
Real-world data demonstrate abrocitinib’s effectiveness in Chinese patients with moderate-to-severe AD. Abrocitinib also improves sleep, and is well tolerated by young adults treated for up to 4.5 years.