Abrocitinib, dupilumab restore skin barrier function in AD, but differ in proteomics

Treatment with abrocitinib or dupilumab results in the restoration of skin barrier function in patients with atopic dermatitis (AD), but these therapies show distinct proteomic impacts, according to a study.

Thirty-three patients with moderate-to-severe AD were randomly allocated into two treatment arms: dupilumab (n=16) and abrocitinib (n=17). The investigators assessed clinical outcomes and skin barrier parameters (ie, transepidermal water loss and hydration) at baseline, 4 weeks, and 12 weeks). They also collected skin tape strips for four-dimensional data-independent acquisition-based proteomics.

Both dupilumab and abrocitinib exhibited improvements in skin barrier function, with the latter achieving superior reductions in transepidermal water loss in nonlesional skin (p=0.0168).

In proteomic analysis, the authors found differentially expressed proteins predominantly associated with ceramide metabolism, neurobiology, and keratinocyte biology in AD. They also identified potential biomarkers, including arginase 1 and proteasome subunit beta type-6 in lesional skin, alongside grancalcin and phospholipase D3 in nonlesional skin

Moreover, abrocitinib improved the expression of crucial barrier proteins, such as filaggrin-2 and loricrin, in lesional skin. This effect was not seen with dupilumab.

“While both abrocitinib and dupilumab effectively restore skin barrier function in AD, they exhibit distinct proteomic impacts,” the authors said.

This study, however, was limited by its small sample size.