Treatment Patterns and Efficacy in Biologic-Exposed and Biologic-Naive Patients With Moderate-to-Severe Atopic Dermatitis: JADE REAL Post Hoc Analysis
Bibliographic record
Abstract
Introduction Abrocitinib, an oral Janus kinase (JAK) 1-selective inhibitor, is approved to treat moderate-to-severe atopic dermatitis (AD) in patients aged ≥12 years. Many patients initiating abrocitinib in the real world have received prior biologic therapy but are under-represented in clinical trials. The primary objective of JADE REAL (NCT04564755), a global, open-label, expanded access protocol study, was to provide early access to abrocitinib for patients for whom available and approved medications for AD were inadequate. This post-hoc analysis of JADE REAL examined treatment patterns and exploratory efficacy outcomes by prior biologic exposure. Methods Patients initiated daily abrocitinib 100 or 200 mg, per investigator discretion, with dose switching allowed to simulate the real-world use of JAK inhibitors. Baseline patient characteristics, prior biologic use (exposed and naive), and use of concomitant rescue medications were collected. Treatment patterns and Eczema Area and Severity Index (EASI) total score, percentage body surface area (%BSA) involvement, Peak Pruritus Numerical Rating Scale (PP-NRS), and Patient-Oriented Eczema Measure (POEM) at Week 72 were described. Results Overall, 89 biologic-exposed and 223 biologic-naive patients were included. Demographic and disease characteristics were similar between groups. A higher proportion of exposed patients initially received abrocitinib 200 mg (61 [68.5%]) than naive patients (131 [58.7%]) and had ≥1 dose change in both initial dose groups (initial dose 100 mg, 15 [53.6%]; 200 mg, 27 [44.3%]) than naive patients (100 mg, 27 [29.3%]; 200 mg, 46 [35.1%]). Median (IQR) abrocitinib treatment duration was similar among exposed and naive patients (351.0 [259.0-500.0] & 378.0 [246.0-510.0] days). Exposed and naive patients demonstrated improvements in the mean (SD) from baseline to Week 72 for EASI total score (20.1 [12.3]-3.0 [6.6] & 23.3 [12.8]-3.9 [7.8]), %BSA involvement (32.5 [21.4]-4.6 [9.5] & 35.1 [21.4]-8.2 [16.0]), PP-NRS (7.2 [2.2]-1.6 [1.6] & 7.5 [2.0]-2.4 [2.4]) and POEM (19.7 [5.7]-4.3 [4.0] & 20.2 [5.6]-7.0 [7.7]). Few exposed and naive patients required concomitant rescue treatments (6 [6.7%]; 10 [4.5%]). Conclusions Biologic-exposed and -naive patients with moderate-to-severe AD receiving abrocitinib in JADE REAL experienced improvements in EASI total score, %BSA involvement, PP-NRS, and POEM; few required concomitant rescue medications. Abrocitinib flexible dosing enables optimized treatment for biologic-naive patients and biologic-exposed patients, which are a difficult-to-treat population. Funding This study was funded by Pfizer.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.008 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.004 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".