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Dr Emma Guttman-Yassky: Strong Real-World Results of Biologics, JAK Inhibitors in AD


Some of the results with biologics and Janus kinase (JAK) inhibitors for atopic dermatitis have been better in practice compared with clinical trials, said Emma Guttman-Yassky, MD, PhD, FAAD, of the Icahn School of Medicine at Mount Sinai.

It’s not uncommon for real-world results and outcomes for a treatment to be worse than those seen in clinical trials, which are more tightly controlled and have strict inclusion criteria. However, some of the results with biologics and Janus kinase (JAK) inhibitors for atopic dermatitis have been better in practice, said Emma Guttman-Yassky, MD, PhD, FAAD, the Waldman Professor and System Chair of Dermatology and Immunology at the Icahn School of Medicine at Mount Sinai, the director of the Center for Excellence in Eczema and the Occupational Dermatitis Clinic, and director of the Laboratory for Inflammatory Skin Diseases.

The first biologic to treat atopic dermatitis was approved in 2017 and the first oral JAK inhibitors were approved in January 2022.


With a couple of years of data of real-world use for biologics and JAK inhibitors to treat atopic dermatitis, what have you seen regarding real-world adherence and efficacy compared with what was seen in the clinical trials?

So yes, for some, actually, we see better results in practice. One such drug is tralokinumab, which targets IL-13. I have to say, I have a very good experience in real life. Part of it is that in the clinical trial, they had a very long washout from topical steroids, and that may have resulted in less good data. But we have good experience now in the real life and also less conjunctivitis, so I think that is good.

Also, I have very good experience now with the JAK inhibitors, both upadacitinib, and also very good experience with abrocitinib from Pfizer—maybe a little bit better than what we've seen in clinical studies. We need to remember their clinical study was 12 weeks, whereas upadacitinib was 16 weeks, and that may make some difference. But we see very good results in real life.

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