Response to biological drugs and JAK inhibitors following cyclosporine in patients with atopic dermatitis

Background: The therapeutic arsenal for atopic dermatitis (AD) has increased in recent years. The use of biologics or Janus kinase inhibitors (JAKi) is advocated following failure or contraindication to cyclosporine (CSA), however, it is not known whether treatment with CSA can impact the response to biologics or JAKi. Objectives: : The aim of this study was to evaluate the effect of previous treatment with CSA on response to biologics or JAKi in patients with AD. Materials & Methods: : This was a retrospective observational study including patients with AD treated for 16 weeks with a biologic or JAKi, who had previously received cyclosporine for at least four weeks. Results: : Thirty patients with AD, with a mean age of 25.07 +/- 9.91 years, of whom 18 (60%) were women, were included. The mean duration of CSA treatment was 43.39 +/- 31.32 weeks. After 16 weeks of biologic or JAKi treatment, 17 (56.7%) patients achieved EASI75. These patients had a higher cumulative dose of CSA (3,6815 vs .76,993.33 mg; p =0.022) and a longer treatment duration (24.5 vs .57.4 weeks; p =0.003). Additionally, a negative correlation was observed between cumulative dose of CSA and EASI or SCORAD at 16 weeks. Conclusion: : Previous cumulative dose and longer duration of CSA treatment does not appear to have a negative impact on response to biologics and JAKi in patients with AD.