Abstract：
The authors evaluated the efficacy and safety of baricitinib, a Janus kinase 1/2 inhibitor, for atopic dermatitis (AD) in real-world practice. From August 2021 to September 2022, 36 patients aged ≥15 years with moderate to severe AD were treated with oral baricitinib 4 mg/day plus topical corticosteroids. Baricitinib improved clinical indexes; the percent reduction at weeks 4 and 12 was a median of 69.19% and 69.98% for the Eczema Area and Severity Index (EASI), 84.52% and 76.33% for the Atopic Dermatitis Control Tool, and 76.39% and 64.58% for Peak Pruritus Numerical Rating Score, respectively. The achievement rate of EASI 75 was 38.89% and 33.33% at weeks 4 and 12, respectively. The percent reduction of EASI in the head and neck, upper limbs, lower limbs, and trunk was 56.9%, 68.3%, 80.7%, and 62.5% at week 12, respectively, with a significant difference between the head and neck versus the lower limbs. Baricitinib decreased thymus and activation-regulated chemokine, lactate dehydrogenase, and total eosinophil count at week 4. Baseline EASI of the head and neck negatively correlated with percent reduction of EASI at week 4, while baseline EASI of the lower limbs positively correlated with percent reduction of EASI at week 12. Treatment-emergent adverse events included elevation of creatine phosphokinase (11.1%), herpes labialis (5.6%), furuncle (8.3%), and exacerbation of AD (1%), without serious treatment-emergent adverse events. In this real-world study, baricitinib was well tolerated for patients with AD and achieved therapeutic effects comparable to those in clinical trials. High baseline EASI of the lower limbs might predict good treatment response at week 12, while high baseline EASI of the head and neck might predict poor treatment response at week 4 in baricitinib treatment for AD.
摘要：
作者评估了baricitinib的疗效和安全性，Janus激酶1/2抑制剂，特应性皮炎（AD）在现实世界的实践。从2021年8月至2022年9月，36例年龄≥15岁的中度至重度AD患者口服baricitinib4mg/day加外用皮质类固醇治疗。Baricitinib改善了临床指标；湿疹面积和严重程度指数（EASI）在第4周和第12周的减少百分比中位数为69.19％和69.98％，特应性皮炎控制工具的84.52％和76.33％，峰值瘙痒数值评分为76.39%和64.58%，分别。在第4周和第12周，EASI75的成功率分别为38.89％和33.33％。头部和颈部的EASI减少百分比，上肢,下肢,后备箱是56.9%，68.3%,80.7%,在第12周分别为62.5%，头部和颈部与下肢之间存在显着差异。巴利替尼减少胸腺和活化调节趋化因子，乳酸脱氢酶,第4周时的嗜酸性粒细胞总数。第4周时头颈部的基线EASI与EASI降低百分比呈负相关,而第12周时下肢的基线EASI与EASI降低百分比呈正相关。治疗引起的不良事件包括肌酸磷酸激酶升高（11.1％），唇疱疹（5.6%），糠疹（8.3%），和AD的恶化（1％），没有严重的治疗引起的不良事件。在现实世界的研究中,巴利替尼对AD患者的耐受性良好,取得了与临床试验相当的治疗效果.下肢的高基线EASI可能预测第12周的良好治疗反应，而头部和颈部的高基线EASI可能预测第4周的baricitinib治疗AD的不良治疗反应。
