Characteristics of Adult Patients With Atopic Dermatitis Initiating Biologics and Janus Kinase Inhibitors in the CorEvitas Atopic Dermatitis Registry

Background: Biologics and Janus kinase inhibitors (JAKi) are two advanced systemic treatment options for patients with atopic dermatitis (AD). The decision to initiate one of these therapies is complex and may be driven by many factors. Objectives: This cross-sectional study described and evaluated differences in demographics, clinical characteristics, treatment patterns, and measures of disease severity and patient-reported outcomes in adult patients with AD initiating either a biologic (dupilumab or tralokinumab) or JAKi (abrocitinib or upadacitinib). Methods: A cohort in the prospective, noninterventional CorEvitas AD Registry between 21 July 2020 and 31 July 2023 was used. Results: The study reported 1604 biologic initiations and 354 JAKi initiations. The initiated medication was the first-line systemic among 86.4% of the biologic initiators and 40.7% of the JAKi initiators. In adjusted analyses, factors positively associated with JAKi initiation compared to biologics included living in the Midwest United States (vs. Northeast US, RR = 1.50), worst skin pain in 24 h (RR = 1.05), and prior use of 1 or 2+ systemic therapies (vs. none, RR = 4.30 and 5.49, respectively). Factors positively associated with biologic initiation included history of cancer (RR = 0.33), moderate vIGA-AD^TM (vs. clear, RR = 0.74), hand involvement (RR = 0.73), and worst itch in 24 h (RR = 0.97). Conclusions: In this real-world assessment, certain characteristics differed between adult patients with AD initiating either biologics or JAKi, although some effect sizes were small and may not be clinically meaningful. This descriptive analysis provides the foundational knowledge for future comparative evaluations of biologics and JAKi to help inform therapeutic decisions for patients with AD.