{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,29]],"date-time":"2026-08-29T17:59:53Z","timestamp":1788026393636,"version":"build-2784847793"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2025,11,14]],"date-time":"2025-11-14T00:00:00Z","timestamp":1763078400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,2,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease that can be difficult to manage in moderate-to-severe cases. Baricitinib (a Janus kinase 1\/2 inhibitor) and azathioprine (a traditional immunosuppressant) are both used in the systemic treatment of AD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To compare the efficacy and safety of baricitinib vs. azathioprine, both combined with topical corticosteroids (TCS), in adults with moderate-to-severe AD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this single-centre open-label randomized head-to-head trial (NCT05969730), 40 adults with moderate-to-severe AD were randomly assigned 1 : 1 to receive baricitinib (4\u2005mg daily) or azathioprine (1.52.5\u2005mg kg\u20131 daily), both with TCS and urea 10% cream, for 12 weeks. The primary endpoint was the proportion of patients achieving \u2265 75% reduction in Eczema Area and Severity Index (EASI 75) at week 12.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>At week 12, 65% (n = 13\/20) of patients in the baricitinib + TCS group achieved EASI 75 vs. 15% (n = 3\/20) in the azathioprine + TCS group [difference 50%, 95% confidence interval (CI) 23.9\u201376.1; P = 0.002]. The baseline-adjusted post-treatment mean (SD) EASI scores were 5.60 (7.51) for baricitinib and 12.61 (7.51) for azathioprine (difference \u20137.01, 95% CI \u201311.86 to \u20132.17; P = 0.006), with a large effect size (Cohen\u2019s d = \u20130.93). A \u2265 75% decrease in SCORing Atopic Dermatitis score (SCORAD 75) was achieved by 55% (n = 11\/20) in the baricitinib + TCS group vs. 15% (n = 3\/20) in the azathioprine group (difference 40%, 95% CI 13.2\u201366.8; P = 0.01). Improvements in validated Investigator\u2019s Global Assessment for AD, Itch Numeric Rating Scale (NRS), Skin Pain NRS, Patient-Oriented Eczema Measure, Dermatology Life Quality Index and Hospital Anxiety and Depression Scale scores were found in both groups, with a trend favouring baricitinib, although the differences between groups were not statistically significant. Both treatments were well tolerated, with no serious adverse events or discontinuations recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Baricitinib + TCS demonstrated superior efficacy to azathioprine + TCS in adults with moderate-to-severe AD, both with a well-tolerated safety profile at 12 weeks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjd\/ljaf456","type":"journal-article","created":{"date-parts":[[2025,11,13]],"date-time":"2025-11-13T13:03:29Z","timestamp":1763039009000},"page":"461-469","source":"Crossref","is-referenced-by-count":1,"title":["Efficacy and safety of baricitinib versus azathioprine, both combined with topical corticosteroids, in patients with moderate-to-severe atopic dermatitis: a single-centre randomized open-label trial"],"prefix":"10.1093","volume":"194","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5622-0294","authenticated-orcid":false,"given":"Mohammad","family":"Malekan","sequence":"first","affiliation":[{"name":"Student Research Committee, School of Medicine, Mazandaran University of Medical Sciences , Sari ,","place":["Iran"]},{"name":"Stem Cell and Regenerative Medicine Innovation Center, Tehran University of Medical Sciences , Tehran ,","place":["Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5608-1167","authenticated-orcid":false,"given":"Ghasem","family":"Rahmatpour Rokni","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine, Mazandaran University of Medical Sciences , Sari ,","place":["Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasim","family":"Gholizadeh","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Faculty of Medicine, Mazandaran University of Medical Sciences , Sari ,","place":["Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahsa","family":"Mollapour\u00a0Sisakht","sequence":"additional","affiliation":[{"name":"Biotechnology Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences , Tehran ,","place":["Iran"]},{"name":"Recombinant Vaccine Research Center, Tehran University of Medical Sciences , Tehran ,","place":["Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Mahdi","family":"Parvizi","sequence":"additional","affiliation":[{"name":"Molecular Dermatology Research Center, Shiraz University of Medical Sciences , Shiraz ,","place":["Iran"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Alizadeh-Navaei","sequence":"additional","affiliation":[{"name":"Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences , Sari 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