Real-world Experience of Abrocitinib Treatment in Patients with Atopic Dermatitis and Hand Eczema: Up to 28-week Results from the BioDay Registry

Abstract

Limited daily practice data on the effect of abrocitinib in patients with atopic dermatitis are available. The aim of this multicentre prospective study is to evaluate the effectiveness and safety of abrocitinib in patients with atopic dermatitis treated in daily practice. In a subgroup, the effectiveness of abrocitinib on hand eczema was evaluated. A total of 103 patients from the BioDay registry were included in the study: week 4 (n = 95), week 16 (n = 61) and week 28 (n = 39). At week 28, the Eczema Area and Severity Index (EASI)-50/75/90 was achieved by 81.8%, 57.6%, and 18.2%, respectively, and the weekly average pruritus numerical rating scale ≤ 4 by 62.9%. The effectiveness of abrocitinib was not significantly different between dupilumab non-responders and dupilumab-naïve patients/responders, and between upadacitinib non-responders and upadacitinib-naïve patients/responders. Mean ± standard deviation Hand Eczema Severity Index decreased from 27.4 ± 27.7 at baseline to 7.7 ± 12.1 at week 28 (n = 31). Thirty-two patients (31.1%) discontinued treatment due to ineffectiveness (n = 17), adverse events (n = 9) or both (n = 3). The most frequently reported adverse event was nausea (n = 28). In conclusion, abrocitinib is an effective treatment for atopic dermatitis and can be effective for patients with previous inadequate response to dupilumab or upadacitinib. Furthermore, hand eczema can improve in patients treated with abrocitinib for atopic dermatitis.

Fig. 1

Effectiveness outcomes of abrocitinib treatment. (A) Effectiveness at week 16 based on sub-analyses stratified by ^adupilumab-naïve patients/responders and ^bdupilumab non-responders (analysed with linear regression model). Data after multiple imputation. (B) Effectiveness at week 16 based on sub-analyses stratified by ^aupadacitinib-naïve patients/responders and ^bupadacitinib non-responders (analysed with linear regression model). Data after multiple imputation. (C) Effectiveness up to 28 weeks of the total cohort (raw data). Eczema Area and Severity Index (EASI): ^aMissing = 6 ^bMissing = 4 ^cMissing = 2 ^dMissing = 6. Numerical rating scale (NRS)-pruritus: ^aMissing = 5 ^bMissing = 0 ^cMissing = 0 ^dMissing = 4. Dermatology Life Quality Index (DLQI): ^aMissing = 32 ^bMissing = 39 ^cMissing = 27 ^dMissing = 16. Patient-Oriented Eczema Measure (POEM): ^aMissing = 33 ^bMissing = 40 ^cMissing = 27 ^dMissing = 16. dup-naïve/R: dupilumab-naïve patients/responders; dup-NR: dupilumab non-responders; upa-naïve/R: upadacitinib-naïve patients/responders; upa-NR: upadacitinib non-responders; N: number; ns: non-significant.

Fig. 2

Effectiveness up to 28 weeks of the total cohort. Proportion of patients who achieved an Eczema Area and Severity Index (EASI) ≤ 7, EASI ≤ 4, Investigator Global Assessment (IGA) ≤ 1, numerical rating scale (NRS)-pruritus ≤ 4, Patient-Oriented Eczema Measure (POEM) ≤ 7, Dermatology Life Quality Index (DLQI) ≤ 5, Atopic Dermatitis Control Tool (ADCT) < 7 or Patient Global Assessment of Disease (PGAD) ≥ 3.

Fig. 3

Flowchart of patients during abrocitinib treatment (n = 103).