JAK Inhibitors in Atopic Dermatitis: Does Weight Matter? A Real-World, Nationwide Retrospective Study: IL-AD (Italian Landscape Atopic Dermatitis)
Open accessAbstract
INTRODUCTION: Janus kinase (JAK) inhibitors are effective systemic treatments for moderate-to-severe atopic dermatitis (AD), rapidly controlling symptoms and improving quality of life. However, the impact of body mass index (BMI) on therapeutic response remains unclear. METHODS: This multicenter retrospective study analyzed data from 388 adult AD patients treated with upadacitinib, abrocitinib, or baricitinib across 25 Italian dermatology centers between May 2022 and July 2024. Patients were classified as overweight (BMI ≥ 25) or non-overweight (BMI < 25), with disease severity assessed using EASI, IGA, and Numerical Rating Scales (NRS) for pruritus and sleep disturbance over 104 weeks. The effect of different treatment dosages was also evaluated. RESULTS: No significant BMI-related differences in clinical outcomes were noted at most timepoints. However, in the upadacitinib 15 mg group, non-overweight patients showed greater EASI and pruritus improvements at Week 4 (p = 0.037, p = 0.039), although these differences resolved subsequently. At Week 104, higher BMI modestly reduced EASI improvement (p = 0.045) in multivariable analysis. CONCLUSIONS: Treatment dosage consistently influenced clinical improvement regardless of BMI. These findings confirm the efficacy of JAK inhibitors across BMI categories, suggesting minimal short-term BMI influence but highlighting potential long-term considerations in overweight patients, emphasizing personalized dosing strategies and prolonged monitoring.
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Recent real-world evidence supports the effectiveness of JAK inhibitors in moderate-to-severe atopic dermatitis, particularly in patients with inadequate response to biologic therapies.
“Recent real-world evidence further supports the effectiveness of JAK inhibitors in moderate-to-severe atopic dermatitis, particularly in patients with inadequate response to biologic therapies [11,16,17,18,19].”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [17]
The Discussion (page not provided) reports that this real-world study found JAK inhibitors effective in adults with moderate-to-severe atopic dermatitis. The Methods allow enrollment after ineffective biologic treatment, and the Results report prior dupilumab use, but the cited passages do not show effectiveness specifically among patients with inadequate response to biologics. (LLM, conf=0.86)
Experimental — accuracy not yet measuredEmerging strategies for atopic dermatitis include microbiome modulation, neuroimmune pathway targeting, and biomarker-guided treatment selection.
“Emerging strategies include microbiome modulation, neuroimmune pathway targeting, and biomarker-guided treatment selection, reflecting an evolving precision medicine approach in atopic dermatitis.”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [17]
The Introduction discusses targeted biologics and JAK inhibitors, while the Discussion considers individualized dosing based on BMI; neither addresses the specific strategies attributed to the paper. Searches for microbiome modulation, neuroimmune targeting, and biomarker-guided treatment selection found no supporting passage in our copy (page numbers unavailable). (LLM, conf=0.77)
Experimental — accuracy not yet measured
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Cites
Guttman-Yassky, E., Teixeira, H. D., Simpson, E. L., Papp, K. A., Pangan, A. L., Blauvelt, A., Thaçi, D., Chu, C.-Y., Hong, H. C.-H., Katoh, N., et al. (2021) · The Lancet · doi:10.1016/s0140-6736(21)00588-2 · Cited by 583 · see citing works
Simpson, E. L., Sinclair, R., Forman, S., Wollenberg, A., Aschoff, R., Cork, M., Bieber, T., Thyssen, J. P., Yosipovitch, G., Flohr, C., et al. (2020) · The Lancet · doi:10.1016/s0140-6736(20)30732-7 · Cited by 522 · see citing works
Zhang, A., & Silverberg, J. I. (2015) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2014.12.013 · Cited by 287 · see citing works
Exploring the Links between Obesity and Psoriasis: A Comprehensive Review
Barros, G., Durán, P., Vera, I., & Bermúdez, V. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23147499 · Cited by 130 · see citing works
Wan, H., Jia, H., Xia, T., & Zhang, D. (2022) · Dermatologic Therapy · doi:10.1111/dth.15636 · Cited by 109 · see citing works
Torrelo, A., Rewerska, B., Galimberti, M. L., Paller, A. S., Yang, C., Prakash, A., Zhu, D., Filho, M. A. G. P., Wu, W.-S., & Eichenfield, L. F. (2023) · British Journal of Dermatology · doi:10.1093/bjd/ljad096 · Cited by 90 · see citing works
Giles, J. T., Ogdie, A., Gómez-Reino, J. J., Helliwell, P., Germino, R., Stockert, L., Young, P., Joseph, W., Mundayat, R., Graham, D., et al. (2021) · RMD Open · doi:10.1136/rmdopen-2020-001486 · Cited by 39 · see citing works
Exploiting the obesity-associated immune microenvironment for cancer therapeutics
Desharnais, L., Walsh, L. A., & Quail, D. F. (2021) · Pharmacology & Therapeutics · doi:10.1016/j.pharmthera.2021.107923 · Cited by 31 · see citing works
Farraye, F. A., Qazi, T., Kotze, P. G., Moore, G. T., Mundayat, R., Lawendy, N., Sharma, P. P., & Judd, D. T. (2021) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.16439 · Cited by 31 · see citing works
Dikranian, A. H., González-Gay, M. Á., Wellborne, F. R., Álvaro‐Gracia, J. M., Takiya, L., Stockert, L., Paulissen, J. B., Shi, H. H., Tatulych, S., & Curtis, J. R. (2022) · RMD Open · doi:10.1136/rmdopen-2021-002103 · Cited by 31 · see citing works
Rossi, M., Bettolini, L., Artelli, G. L., Fraghì, A., Tomasi, C., & Calzavara‐Pinton, P. (2023) · Journal of Asthma and Allergy · doi:10.2147/jaa.s433515 · Cited by 18 · see citing works
Ibba, L., Gargiulo, L., Bianco, M., Giulio, S. D., Ingurgio, R. C., Alfano, Â., Vignoli, C. A., Valenti, M., Facheris, P., Perugini, C., et al. (2025) · Clinical and Experimental Dermatology · doi:10.1093/ced/llaf144 · Cited by 18 · see citing works
Park, D.-J., Jeong, H., Choi, S., Kang, J., & Lee, S. (2024) · Therapeutic Advances in Musculoskeletal Disease · doi:10.1177/1759720x241308027 · Cited by 12 · see citing works
Desai, A., Sehgal, P., Khataniar, H., Lewis, J. D., Farraye, F. A., Lichtenstein, G. R., & Kochhar, G. S. (2025) · Alimentary Pharmacology & Therapeutics · doi:10.1111/apt.18513 · Cited by 12 · see citing works
Nicolosi, S., Barei, F., Romagnuolo, M., Fumagalli, S., Marzano, A. V., & Ferrucci, S. M. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13154559 · Cited by 8 · see citing works
Novella-Navarro, M., Rym, A. M. V. D., López-Pedrera, C., Martínez‐Feito, A., Nieto-Carvalhal, B., Reche-Yebra, K., López‐Medina, C., Escudero‐Contreras, A., Nozal, P., Miranda‐Carús, M., et al. (2025) · Nutrients · doi:10.3390/nu17050820 · Cited by 4 · see citing works
Obesity might not alter tofacitinib drug survival in rheumatoid arthritis patients
Erdoğan, E. K., Armağan, B., Ulucaköy, R. K., Orhan, K., Güven, S. C., Özdemir, B., Konak, H. E., Karakaş, Ö., Dağlı, P. A., Atalar, E., et al. (2024) · Wiener klinische Wochenschrift · doi:10.1007/s00508-024-02424-3 · Cited by 2 · see citing works
Flagged first, then by citations
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Sorted by citations
Tinca, A. C., Cozac-Szoke, A. R., & Cotoi, O. S. (2026) · Dermatopathology · doi:10.3390/dermatopathology13020022 · Cited by 1 · see citing works
Bighetti, S., Bettolini, L., Zerbinati, N., Carugno, A., Fratton, Z., Errichetti, E., Pezzolo, E., Venturini, M., & Rossi, M. (2026) · Clinical Cosmetic and Investigational Dermatology · doi:10.2147/ccid.s584984
“23,24 In our cohort, the majority of patients were receiving biologic therapies, which generally require less daily caregiver involvement compared with complex topical regimens.”
Karakoyun, Ö., & Ayhan, E. (2026) · Pharmaceuticals · doi:10.3390/ph19060828
“Obesity may contribute to systemic inflammatory burden and epidermal barrier dysfunction, thereby aggravating disease severity and potentially attenuating treatment responsiveness [24,25].”
Adam, D. N., Dhadwal, G., Grewal, P. S., Ringuet, J., Turchin, I., & Beecker, J. R. (2026) · Dermatologic Therapy · doi:10.1155/dth/6874662
Wang, Y., Qin, H., Gao, Y., Li, Z., Wu, Y., Yin, H., Wang, S., Yao, X., Wu, H., & Gu, C. (2026) · Annals of Medicine · doi:10.1080/07853890.2026.2720965
“This evolving treatment paradigm is supported by recent expert guidance and real-world evidence showing that dose adjustment and treatment modification are common, clinically relevant components of JAK inhibitor therapy [16–20].”
- Authors
- Rossi, M., Bighetti, S., Narcisi, A., Costanzo, A., Bianco, M., Malagoli, P., Messina, F., Gaiani, F., Ferrucci, S. M., Marzano, A. V., Barei, F., Ribero, S., Ortoncelli, M., Leo, F., Napolitano, M., Cosenza, A., Patruno, C., Guanti, M. B., Balato, A., Loconsole, F., Sciarrone, C., Veronese, F., Pezzolo, E., Burroni, A. G., Gola, M., Gurioli, C., Margiotta, F. M., Musumeci, M. L., Satolli, F., Amoruso, G., Esposito, M., Foti, C., Pella, P., Campanati, A., Carugno, A., Zerbinati, N., Maurelli, M., Trave, I., Calzavara-Pinton, P., & Bettolini, L.
- Affiliations
- Azienda Socio Sanitaria Territoriale degli Spedali Civili di Brescia (IT)
- IRCCS Humanitas Research Hospital (IT)
- IRCCS Policlinico San Donato (IT)
- Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico (IT)
- University of Milan (IT)
- University of Turin (IT)
- University of Naples Federico II (IT)
- University of Molise (IT)
- University of Modena and Reggio Emilia (IT)
- University of Campania "Luigi Vanvitelli" (IT)
- University of Bari Aldo Moro (IT)
- Azienda Ospedaliera Ospedali Riuniti Papardo Piemonte (IT)
- Azienda Ospedaliero Universitaria Maggiore della Carita (IT)
- Ospedale San Bortolo (IT)
- Ospedale Policlinico San Martino (IT)
- University of Florence (IT)
- IRCCS Azienda Ospedliero-Universitaria di Bologna Policlinico di Sant'Orsola (IT)
- University of Pisa (IT)
- University of Catania (IT)
- University of Parma (IT)
- Azienda Ospedaliera di Cosenza (IT)
- University of L'Aquila (IT)
- Ospedale degli Infermi (IT)
- Marche Polytechnic University (IT)
- University of Insubria (IT)
- University of Verona (IT)
- Corresponding author
- Bettolini, Luca
- ORCID
- Rossi, Mariateresa
- Bighetti, Stefano
- Narcisi, Alessandra
- Costanzo, Antonio
- Malagoli, Piergiorgio
- Messina, Francesco
- Gaiani, Francesca
- Ferrucci, Silvia Mariel
- Marzano, Angelo Valerio
- Barei, Francesca
- Ribero, Simone
- Ortoncelli, Michela
- Napolitano, Maddalena
- Patruno, Cataldo
- Guanti, Mario Bruno
- Loconsole, Francesco
- Veronese, Federica
- Pezzolo, Elena
- Burroni, Anna Graziella
- Gola, Massimo
- Gurioli, Carlotta
- Margiotta, Flavia Manzo
- Musumeci, Maria Letizia
- Satolli, Francesca
- Esposito, Maria
- Foti, Caterina
- Campanati, Anna
- Carugno, Andrea
- Zerbinati, Nicola
- Maurelli, Martina
- Trave, Ilaria
- Bettolini, Luca
- Venue
- Dermatology and Therapy
- Published
- 2025-07-24
- Volume
- 15
- Issue
- 10
- Pages
- 2833-2851
- ISSN
- 2190-9172 (ISSN-L)
- 2193-8210
- PMC
- PMC12454714
- OpenAlex
- W4412644883
- Cited by
- 5
- References
- 17
- Citations by year
- 2026: 5
- FWCI
- 4.79
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Dermatology and Therapy (publishedVersion, cc-by-nc)
- Europe PMC (PubMed Central) (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- PubMed Central (publishedVersion, cc-by-nc)
- Archivio Istituzionale della Ricerca - Università degli Studi dell Aquila (submittedVersion, cc-by-nc)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- IrInSubria (University of Insubria) (submittedVersion, cc-by-nc)
- Institutional Research Information System (Università degli Studi di Brescia) (submittedVersion, other-oa)
- Archivio Istituzionale della Ricerca - Università degli Studi del Molise (submittedVersion)
- CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion)
- Funders
- Amgen
- Eli Lilly and Company
- Pfizer
- Sanofi
- Biogen
- Celgene
- Incyte
- Galderma
- LEO Pharma
- Sanofi Genzyme
- UCB Pharma
- Cilag
- Topics
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Life Sciences › Immunology and Microbiology › Immunology › Psoriasis: Treatment and Pathogenesis
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Keywords
- atopic dermatitis, JAK inhibitors, body mass index, upadacitinib, abrocitinib, baricitinib, overweight, treatment dosage, pruritus, EASI, sleep disorders, individualized dosing
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