A RECENT nationwide study conducted in Italy provides important insights into how body weight may influence the efficacy of JAK inhibitors in treating moderate-to-severe atopic dermatitis (AD). The study, which involved 388 adult patients from 25 dermatology centers, aimed to assess the impact of BMI on clinical outcomes in patients treated with upadacitinib, abrocitinib, or baricitinib. The findings, though interesting, suggest that while BMI may have some effect on short-term outcomes, JAK inhibitors remain effective across both overweight and non-overweight patients.
The study classified patients into two groups: overweight (BMI≥25) and non-overweight (BMI<25). Disease severity was assessed using standard tools, including the Eczema Area and Severity Index (EASI), Investigator Global Assessment (IGA), and the Numerical Rating Scales (NRS) for pruritus and sleep disturbance. While no significant differences were observed in clinical outcomes between the two BMI groups across most time points, some early variations were noted. In the upadacitinib 15 mg group, non-overweight patients experienced greater improvements in EASI and pruritus at Week 4, though these differences did not persist in the long term. By Week 104, higher BMI slightly reduced EASI improvement, though this effect was modest and not clinically significant in most cases. Ultimately, the study confirmed that treatment dosages played a more prominent role in determining clinical improvement than BMI. The authors suggest that while BMI may not drastically impact the short-term efficacy of JAK inhibitors, personalized dosing strategies and long-term monitoring could help address potential concerns for overweight patients. These findings underscore the continued importance of individualized treatment approaches in AD management. Reference: Rossi M et al. JAK Inhibitors in Atopic Dermatitis: Does Weight Matter? A Real-World, Nationwide Retrospective Study: IL-AD (Italian Landscape Atopic Dermatitis). Dermatol Ther (Heidelb). 2025. doi: 10.1007/s13555-025-01477-0.
