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启动生物制剂与JAK抑制剂的特应性皮炎患者基线人口统计学特征和合并症的比较真实世界分析

Comparative Real-World Analysis of Baseline Demographic Characteristics and Comorbidities in Atopic Dermatitis Patients Initiating Biologics Versus JAK Inhibitors.

作者信息

Prados-Carmona Alvaro, Navarro-Triviño Francisco J, Husein-ElAhmed Husein, Ruiz-Villaverde Ricardo

机构信息

Department of Dermatology, Hospital Universitario San Cecilio, 18016 Granada, Spain.

Instituto Biosanitario de Granada, Ibs, 18001 Granada, Spain.

出版信息

J Clin Med. 2025 Feb 15;14(4):1291. doi: 10.3390/jcm14041291.

Abstract

: Systemic advanced therapies, including biologic drugs and Janus kinase (JAK) inhibitors, have revolutionized atopic dermatitis management. The increasing number of available options for such complex diseases demands careful treatment selection for each patient, considering numerous variables. Comparative analyses of these treatment modalities in the real world are still limited. Only a faithful basal characterization would enable posterior meaningful and accurate comparisons of the efficacy and safety profiles of these groups of drugs. This communication focuses on describing and comparing the baseline demographics and comorbidities of patients with atopic dermatitis currently treated with biologic therapies versus JAK inhibitors in our setting. : We conducted an observational, descriptive, and ambispective study across three hospitals covering a population of over 500,000 inhabitants from January 2019 to December 2024. Baseline demographic data, anthropometric measures, lifestyle factors, cardiovascular risk factors, and comorbidities were analyzed using descriptive and inferential statistics. Additionally, basal severity and effectivity over time have also been compared. : A total of 150 patients were analyzed. A total of 102 had received biological therapies (dupilumab or tralokinumab), whereas 48 patients had received JAK inhibitors (upadacitinib, baricitinib, or abrocitinib). Ages ranged from 11 to 76 years. The overall cohort had a mean age of 35.87 ± 14.37 years and a male predominance (male-to-female ratio 1.63:1). Hypertension was more prevalent in the JAK inhibitors group ( = 0.0175), yet other cardiovascular risk factors, body measurements, atopic and non-atopic comorbidities, and disease severity were comparable across both groups. : This study helped to characterize the baseline characteristics of patients treated with advanced systemic therapies in a real-world clinical setting. It pointed to just slight differences between the profiles of patients treated with biologics versus JAK inhibitors. This homogeneity in baseline characteristics sets the ground for further future comparisons of treatment outcomes in this cohort as potential confounding factors related to group imbalances are minimized.

摘要

全身性先进疗法,包括生物药物和 Janus 激酶(JAK)抑制剂,彻底改变了特应性皮炎的治疗方式。对于这类复杂疾病,可用治疗方案日益增多,这就需要针对每位患者,综合考虑众多变量,谨慎选择治疗方法。在现实世界中,对这些治疗方式的比较分析仍然有限。只有进行准确的基线特征描述,才能对这些药物组的疗效和安全性进行有意义且准确的后续比较。本交流重点描述并比较了在我们的研究环境中,目前接受生物疗法与 JAK 抑制剂治疗的特应性皮炎患者的基线人口统计学特征和合并症。

我们在 2019 年 1 月至 2024 年 12 月期间,对三家医院进行了一项观察性、描述性和双向性研究,覆盖人口超过 50 万。使用描述性和推断性统计方法分析基线人口统计学数据、人体测量指标、生活方式因素、心血管危险因素和合并症。此外,还比较了基线严重程度和随时间的有效性。

共分析了 150 名患者。其中 102 名接受了生物疗法(度普利尤单抗或曲罗芦单抗),而 48 名患者接受了 JAK 抑制剂(乌帕替尼、巴瑞替尼或阿布昔替尼)。年龄范围为 11 至 76 岁。整个队列的平均年龄为 35.87 ± 14.37 岁,男性占主导(男女比例为 1.63:1)。高血压在 JAK 抑制剂组中更为普遍(P = 0.0175),但两组在其他心血管危险因素、身体测量指标、特应性和非特应性合并症以及疾病严重程度方面相当。

本研究有助于在现实临床环境中描述接受先进全身疗法患者的基线特征。研究表明,接受生物制剂治疗的患者与接受 JAK 抑制剂治疗的患者之间仅有细微差异。基线特征的这种同质性为进一步比较该队列的治疗结果奠定了基础,因为与组间失衡相关的潜在混杂因素已降至最低。

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本文引用的文献

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Anti-OX40 Biological Therapies in the Treatment of Atopic Dermatitis: A Comprehensive Review.
J Clin Med. 2024 Nov 17;13(22):6925. doi: 10.3390/jcm13226925.
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Comparative effectiveness of upadacitinib versus dupilumab for moderate-to-severe atopic dermatitis: A retrospective cohort study.
Int Immunopharmacol. 2024 Dec 25;143(Pt 1):113383. doi: 10.1016/j.intimp.2024.113383. Epub 2024 Oct 14.
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Infection risk with JAK inhibitors in dermatoses: a meta-analysis.
Int J Dermatol. 2025 Jan;64(1):24-36. doi: 10.1111/ijd.17501. Epub 2024 Oct 4.
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Comparative safety of oral Janus kinase inhibitors versus dupilumab in patients with atopic dermatitis: A population-based cohort study.
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Increased cardiovascular risks and mortality in prurigo nodularis: a global cohort study.
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