Horie Akihiro, Miyagaki Tomomitsu, Hiranuma Chikako, Iijima Mami, Hara Yoshiaki, Oba Shinya, Hashimoto Mina, Omori Reina, Okano Tatsuro, Kadono Takafumi
Department of Dermatology, St. Marianna University School of Medicine, 2-16-1 Sugao, Miyamae-ku, Kawasaki 216-0015, Japan.
Medicina (Kaunas). 2025 May 20;61(5):926. doi: 10.3390/medicina61050926.
Several biologics and oral Janus kinase (JAK) inhibitors have been developed and shown in clinical trials and real-world studies to be effective and safe in moderate-to-severe atopic dermatitis (AD). In this study, we aimed to evaluate the real-world outcomes of patients with moderate-to-severe AD treated with dupilumab and JAK inhibitors in our facility, focusing on their short-term effect on serum galectin-7 levels, a biomarker reflecting skin barrier impairment, and one-year stability based on patient-oriented outcomes. In a single-center, retrospective study of AD patients treated with dupilumab or JAK inhibitors between January 2018 and December 2024, we assessed physician-oriented outcomes until 16 weeks and patient-oriented outcomes until 52 weeks. Serum galectin-7 levels at baseline and 4 and/or 16 weeks after treatment were measured in 14 patients. A total of 45 patients starting dupilumab and 10 patients starting JAK inhibitors were enrolled. Percentage reductions in EASI scores from baseline at 4, 8, and 16 weeks were 58.36 ± 22.09, 69.59 ± 20.96, and 75.98 ± 19.70, with no significant differences between patients treated with dupilumab and JAK inhibitors. Serum galectin-7 levels were significantly reduced after treatment at 4 and 16 weeks in the entire population. Both DLQI and POEM scores were reduced at 4 weeks and gradually decreased until 52 weeks. The reduction was faster with JAK inhibitors than with dupilumab. Visits with unstable effectiveness, defined as a visit with a three-point or greater increase in the POEM score at 28, 40, and 52 weeks, were more frequent in JAK inhibitor patients. Both dupilumab and JAK inhibitors showed high effectiveness on skin inflammation and decreased a marker of skin barrier dysfunction within 16 weeks. JAK inhibitors improved patient-reported outcomes more quickly than dupilumab, but instability of effectiveness during 16 and 52 weeks was higher with JAK inhibitors.
几种生物制剂和口服 Janus 激酶（JAK）抑制剂已被研发出来，并在临床试验和真实世界研究中显示对中重度特应性皮炎（AD）有效且安全。在本研究中，我们旨在评估在我们机构中接受度普利尤单抗和 JAK 抑制剂治疗的中重度 AD 患者的真实世界结局，重点关注它们对血清半乳糖凝集素 -7 水平（一种反映皮肤屏障受损的生物标志物）的短期影响以及基于以患者为导向的结局的一年稳定性。在一项对 2018 年 1 月至 2024 年 12 月期间接受度普利尤单抗或 JAK 抑制剂治疗的 AD 患者的单中心回顾性研究中，我们评估了直至 16 周的以医生为导向的结局以及直至 52 周的以患者为导向的结局。对 14 名患者测量了基线以及治疗后 4 周和 / 或 16 周时的血清半乳糖凝集素 -7 水平。共有 45 名开始使用度普利尤单抗的患者和 10 名开始使用 JAK 抑制剂的患者入组。在 4 周、8 周和 16 周时，EASI 评分相对于基线的降低百分比分别为 58.36 ± 22.09、69.59 ± 20.96 和 75.98 ± 19.70，接受度普利尤单抗和 JAK 抑制剂治疗的患者之间无显著差异。在整个人口中，治疗后 4 周和 16 周时血清半乳糖凝集素 -7 水平显著降低。DLQI 和 POEM 评分在 4 周时降低，并在直至 52 周时逐渐下降。JAK 抑制剂的降低速度比度普利尤单抗更快。在 28 周、40 周和 52 周时，定义为 POEM 评分增加三分或更多的疗效不稳定就诊在 JAK 抑制剂治疗的患者中更频繁。度普利尤单抗和 JAK 抑制剂在 16 周内均对皮肤炎症显示出高效，并降低了皮肤屏障功能障碍的标志物。JAK 抑制剂比度普利尤单抗更快地改善了患者报告的结局，但在 16 周和 52 周期间 JAK 抑制剂的疗效不稳定性更高。
