Baricitinib for adult atopic dermatitis: real-world effectiveness, safety, and response predictors
Year: 2025
Type: article
Study design: Observational Study
Abstract: Objectives Baricitinib has shown efficacy and a favorable safety profile in randomized trials for moderate-to-severe atopic dermatitis (AD), but real-world evidence is limited. We conducted a multicenter, retrospective and prospective study aimed at evaluating the long-term effectiveness and safety profile of baricitinib in the treatment of adult patients affected from AD, with the additional goal of identifying potential predictors of treatment response.Methods We included adult AD patients treated with baricitinib between January 2023 and November 2024 at five Italian tertiary centers. Disease severity and patient-reported outcomes, including the Eczema Area and Severity Index (EASI), Body Surface Area (BSA), Itch Numeric Rating Scale (Itch-NRS), Sleep Numeric Rating Scale (Sleep-NRS), Dermatology Life Quality Index (DLQI), Patient-Oriented Eczema Measure (POEM), and Minimal Disease Activity (MDA, defined as EASI ≤3 and Itch-NRS ≤1), were assessed at baseline and weeks 4, 16, 32, and 52.Results The 52 patients enrolled showed significant and sustained improvements in physician- (BSA, EASI) and patient-reported outcomes (Itch-NRS, Sleep-NRS, DLQI, POEM). At week 16, atopic comorbidities increased the odds of achieving MDA (OR: 10.9; p = 0.033), whereas head and neck involvement reduced the likelihood of response (OR: 0.07 p = 0.028). Thirty-two mild to moderate adverse events occurred in 28 patients, none requiring treatment discontinuation.Conclusion In this real-world study, baricitinib provided substantial long-term effectiveness with a favorable safety profile in moderate-to-severe AD, and atopic comorbidities emerged as a predictor of optimal clinical response at week 16.
Authors: Niccolò Gori, Lucia Di Nardo, Elena Ippoliti, Flaminia Antonelli, Luisa Boeti, Anna Balato, Eugenia Veronica Di Brizzi, Maddalena Nicoletti, Maria Esposito, Maria Concetta Fargnoli, Andrea De Berardinis, Lina Maria Magnanimi, Marco Galluzzo, Claudia Paganini, Marina Talamonti, Luca Bianchi, Maddalena Napolitano, Cataldo Patruno, Giuseppe Lauletta, Francesca di Vico, Ketty Peris
Institutions: Università Cattolica del Sacro Cuore, Agostino Gemelli University Polyclinic, Istituti di Ricovero e Cura a Carattere Scientifico, University of Campania "Luigi Vanvitelli", University of L'Aquila, San Salvatore Hospital, University of Rome Tor Vergata, Policlinico Tor Vergata, University of Molise, University of Naples Federico II
Language: English
Subfield: Dermatology
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W4415802248