JAK-1 inhibitors in the management of atopic dermatitis in patients over 65 years old: a descriptive cohort study

Atopic dermatitis (AD) can affect older adults. Janus kinase inhibitors (JAK-1 inhibitors), such as upadacitinib and abrocitinib, have emerged as effective treatments for moderate-to-severe AD. However, data on their safety and efficacy in older adults remain limited due to underrepresentation in clinical trials. This retrospective cross-sectional study examined the efficacy and safety of oral JAK-1 inhibitors in patients aged 65 years or older. Data was extracted from electronic medical records. Disease control was assessed using the Atopic Dermatitis Control Tool (ADCT), while adverse events were analyzed. Statistical comparisons were conducted using the Wilcoxon Signed-Rank Test. The study included 31 patients. Thirteen patients (42%) received abrocitinib, and 18 (58%) upadacitinib. The mean reduction in ADCT scores was − 84.4%, with a slightly greater improvement observed in abrocitinib users (-5.1%, p < 0.001). Mild adverse events were reported in 21 patients (68%), while 26% experienced no adverse effects. Two patients discontinued treatment due to adverse events. Both upadacitinib and abrocitinib demonstrated substantial efficacy in achieving long term AD control among older adults, with manageable safety profiles. These findings highlight the potential of JAK-1 inhibitors in this population while underscoring the need for personalized treatment approaches and further research in larger cohorts.