{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T11:04:04Z","timestamp":1779879844252,"version":"3.53.1"},"reference-count":42,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Background: Janus kinase (JAK) inhibitors have expanded the therapeutic landscape for moderate-to-severe atopic dermatitis (AD), yet real-world comparative data on upadacitinib and abrocitinib remain limited. Objective: We aimed to compare the 24-week real-world effectiveness and safety of upadacitinib 30 mg and abrocitinib 200 mg in adult patients with moderate-to-severe AD, using EASI-75 as the primary efficacy endpoint, and to explore potential clinical factors associated with treatment response. Methods: This retrospective single-center study included adult patients with moderate-to-severe AD treated with upadacitinib 30 mg or abrocitinib 200 mg and followed for 24 weeks in routine clinical practice. A small pediatric subgroup (n = 3) receiving abrocitinib 100 mg was analyzed separately for descriptive purposes only. Clinical outcomes included Eczema Area and Severity Index (EASI), Peak Pruritus Numerical Rating Scale (PP-NRS), EASI-50\/75\/90 response rates, and NRS-4 response. Safety was assessed using routinely documented adverse events. Exploratory analyses evaluated the possible influence of body mass index (BMI), baseline immunoglobulin E (IgE), and psychological stress on treatment response. Results: Both upadacitinib and abrocitinib were associated with rapid and sustained clinical improvement over 24 weeks. At month 6, EASI-75 response was 83.3% in the upadacitinib group versus 70.8% in the abrocitinib group (p = 0.27). EASI-50 response was significantly higher in the upadacitinib group (100% vs. 83.3%; p = 0.05). Exploratory findings suggested that higher BMI, elevated baseline IgE levels, and psychological stress may be associated with less favorable response trajectories. Both treatments demonstrated a generally favorable safety profile; however, one serious cerebrovascular thrombotic event occurred in a patient with pre-existing cardiovascular risk factors, highlighting the importance of individualized risk assessment when prescribing JAK inhibitors. Conclusions: In routine clinical practice, both upadacitinib and abrocitinib appeared effective for the management of moderate-to-severe AD over 24 weeks. Although upadacitinib 30 mg showed a numerically higher month-6 EASI-50 response, this finding should be interpreted cautiously given the modest sample size and the absence of broader between-group differences across other key efficacy outcomes. Larger prospective studies are needed to confirm comparative effectiveness and to clarify predictors of response and safety in real-world settings.<\/jats:p>","DOI":"10.3390\/ph19060828","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T10:19:52Z","timestamp":1779877192000},"page":"828","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-World Effectiveness and Safety of Upadacitinib Versus Abrocitinib in Moderate-to-Severe Atopic Dermatitis: A Retrospective Cohort Study"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0009-0008-8196-7470","authenticated-orcid":false,"given":"\u00d6mer","family":"Karakoyun","sequence":"first","affiliation":[{"name":"Department of Dermatology and Venereal Diseases, Faculty of Medicine, Dicle University, 21280 Diyarbak\u0131r, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erhan","family":"Ayhan","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Venereal Diseases, Faculty of Medicine, Dicle University, 21280 Diyarbak\u0131r, T\u00fcrkiye"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Lugovi\u0107-Mihi\u0107, L., Barac, E., Toma\u0161evi\u0107, R., Para\u0107, E., Zanze, L., Ljevar, A., Dola\u010dki, L., and \u0160trajtenberger, M. 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