Comparative short-term efficacy of Janus kinase 1 inhibitors and anti-interleukin-13 antibodies in atopic dermatitis: a retrospective cohort analysis based on real-world data

IntroductionMolecular targeted therapies, including advanced atopic dermatitis (AD) treatment with Janus kinase 1 inhibitors (JAK1i) and anti-interleukin-13 antibodies (IL-13Ab), are emerging as effective options. However, the predictive biomarkers for treatment responses remain unclear. Therefore,...

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Main Authors: Emi Sato, Naoko Obonai, Mayuko Iwata, Kotaro Ito, Shinichi Imafuku
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-08-01
Series:Frontiers in Immunology
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Online Access:https://www.frontiersin.org/articles/10.3389/fimmu.2025.1639932/full
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author Emi Sato
Naoko Obonai
Mayuko Iwata
Kotaro Ito
Kotaro Ito
Shinichi Imafuku
author_facet Emi Sato
Naoko Obonai
Mayuko Iwata
Kotaro Ito
Kotaro Ito
Shinichi Imafuku
author_sort Emi Sato
collection DOAJ
description IntroductionMolecular targeted therapies, including advanced atopic dermatitis (AD) treatment with Janus kinase 1 inhibitors (JAK1i) and anti-interleukin-13 antibodies (IL-13Ab), are emerging as effective options. However, the predictive biomarkers for treatment responses remain unclear. Therefore, this study compared the short-term efficacy of JAK1i and IL-13Ab and explored relevant biomarkers.MethodsThis retrospective analysis was conducted in 75 patients with moderate-to-severe AD treated at Fukuoka University Hospital. Relevant biomarkers, including eosinophil count and thymus and activation-regulated chemokine (TARC) levels, were measured at baseline and 3 months. Eczema Area and Severity Index (EASI) and Peak Pruritus Numerical Rating Scale (PP-NRS) scores were also assessed.ResultsPatients received JAK1i (n=37; abrocitinib, n=16; upadacitinib, n=21) or IL-13Ab (n=38; lebrikizumab, n=21; tralokinumab, n=17). At 3 months, no significant difference was observed between JAK1i and IL-13Ab in achieving EASI 75 (odds ratio [OR] = 0.83, p=0.76) or in the incidence of adverse events (OR = 1.40, p=0.55). However, JAK1i was associated with higher odds of achieving PP-NRS 4 (OR=9.36, p=0.0063) and PP-NRS 0/1 (OR=34.61, p<0.0001). In the JAK1i group, eosinophil count reduction correlated with EASI improvement (univariate: R=0.525, p=0.0009; adjusted: β = 0.567, p=0.0004). In the IL-13Ab group, TARC reduction correlated with EASI improvement (univariate: R=0.677, p<0.0001; adjusted: β = 0.661, p<0.0001).ConclusionJAK1i showed greater antipruritic effects than IL-13Ab at 3 months, likely due to interleukin (IL)-31 inhibition. Eosinophil count reduction was the most reflective biomarker of JAK1i efficacy, potentially due to IL-5 suppression, whereas TARC improvement was significantly associated with patients’ treatment response to IL-13Ab. These findings highlight the need for further long-term studies.
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spelling doaj-art-5524908918d64f7ea0713fc43a037e052025-08-20T03:39:26ZengFrontiers Media S.A.Frontiers in Immunology1664-32242025-08-011610.3389/fimmu.2025.16399321639932Comparative short-term efficacy of Janus kinase 1 inhibitors and anti-interleukin-13 antibodies in atopic dermatitis: a retrospective cohort analysis based on real-world dataEmi Sato0Naoko Obonai1Mayuko Iwata2Kotaro Ito3Kotaro Ito4Shinichi Imafuku5Department of Dermatology, Faculty of Medicine, Fukuoka University, Fukuoka, JapanDepartment of Dermatology, Faculty of Medicine, Fukuoka University, Fukuoka, JapanDepartment of Dermatology, Faculty of Medicine, Fukuoka University, Fukuoka, JapanDepartment of Dermatology, Faculty of Medicine, Fukuoka University, Fukuoka, JapanDepartment of Dermatology, Ito Dermatology Clinic, Kitsuki, Oita, JapanDepartment of Dermatology, Faculty of Medicine, Fukuoka University, Fukuoka, JapanIntroductionMolecular targeted therapies, including advanced atopic dermatitis (AD) treatment with Janus kinase 1 inhibitors (JAK1i) and anti-interleukin-13 antibodies (IL-13Ab), are emerging as effective options. However, the predictive biomarkers for treatment responses remain unclear. Therefore, this study compared the short-term efficacy of JAK1i and IL-13Ab and explored relevant biomarkers.MethodsThis retrospective analysis was conducted in 75 patients with moderate-to-severe AD treated at Fukuoka University Hospital. Relevant biomarkers, including eosinophil count and thymus and activation-regulated chemokine (TARC) levels, were measured at baseline and 3 months. Eczema Area and Severity Index (EASI) and Peak Pruritus Numerical Rating Scale (PP-NRS) scores were also assessed.ResultsPatients received JAK1i (n=37; abrocitinib, n=16; upadacitinib, n=21) or IL-13Ab (n=38; lebrikizumab, n=21; tralokinumab, n=17). At 3 months, no significant difference was observed between JAK1i and IL-13Ab in achieving EASI 75 (odds ratio [OR] = 0.83, p=0.76) or in the incidence of adverse events (OR = 1.40, p=0.55). However, JAK1i was associated with higher odds of achieving PP-NRS 4 (OR=9.36, p=0.0063) and PP-NRS 0/1 (OR=34.61, p<0.0001). In the JAK1i group, eosinophil count reduction correlated with EASI improvement (univariate: R=0.525, p=0.0009; adjusted: β = 0.567, p=0.0004). In the IL-13Ab group, TARC reduction correlated with EASI improvement (univariate: R=0.677, p<0.0001; adjusted: β = 0.661, p<0.0001).ConclusionJAK1i showed greater antipruritic effects than IL-13Ab at 3 months, likely due to interleukin (IL)-31 inhibition. Eosinophil count reduction was the most reflective biomarker of JAK1i efficacy, potentially due to IL-5 suppression, whereas TARC improvement was significantly associated with patients’ treatment response to IL-13Ab. These findings highlight the need for further long-term studies.https://www.frontiersin.org/articles/10.3389/fimmu.2025.1639932/fullJanus kinase 1 inhibitorsanti-IL-13 antibodiesIL-31pruritusIL-5eosinophils
spellingShingle Emi Sato
Naoko Obonai
Mayuko Iwata
Kotaro Ito
Kotaro Ito
Shinichi Imafuku
Comparative short-term efficacy of Janus kinase 1 inhibitors and anti-interleukin-13 antibodies in atopic dermatitis: a retrospective cohort analysis based on real-world data
Frontiers in Immunology
Janus kinase 1 inhibitors
anti-IL-13 antibodies
IL-31
pruritus
IL-5
eosinophils
title Comparative short-term efficacy of Janus kinase 1 inhibitors and anti-interleukin-13 antibodies in atopic dermatitis: a retrospective cohort analysis based on real-world data
title_full Comparative short-term efficacy of Janus kinase 1 inhibitors and anti-interleukin-13 antibodies in atopic dermatitis: a retrospective cohort analysis based on real-world data
title_fullStr Comparative short-term efficacy of Janus kinase 1 inhibitors and anti-interleukin-13 antibodies in atopic dermatitis: a retrospective cohort analysis based on real-world data
title_full_unstemmed Comparative short-term efficacy of Janus kinase 1 inhibitors and anti-interleukin-13 antibodies in atopic dermatitis: a retrospective cohort analysis based on real-world data
title_short Comparative short-term efficacy of Janus kinase 1 inhibitors and anti-interleukin-13 antibodies in atopic dermatitis: a retrospective cohort analysis based on real-world data
title_sort comparative short term efficacy of janus kinase 1 inhibitors and anti interleukin 13 antibodies in atopic dermatitis a retrospective cohort analysis based on real world data
topic Janus kinase 1 inhibitors
anti-IL-13 antibodies
IL-31
pruritus
IL-5
eosinophils
url https://www.frontiersin.org/articles/10.3389/fimmu.2025.1639932/full
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