Abstract: Objective: To evaluate the clinical efficacy and safety of abrocitinib in the treatment of elderly patients(≥65 years old) with moderate-to-severe atopic dermatitis (AD) in a real-world setting. Methods: This retrospective study included patients aged ≥65 years with moderate-to-severe AD treated with abrocitinib (100 mg/d or 200 mg/d) at the Department of Dermatology, Wuhan First Hospital, between January 2023 and December 2024. Clinical outcomes were assessed based on changes in the Eczema Area and Severity Index (EASI) and the Peak Pruritus Numerical Rating Scale (NRS) from baseline to Week 12. Adverse events (AEs) were monitored throughout the follow-up period. Results: A total of 38 patients were included. At Week 12, both EASI and NRS scores showed significant reduction compared to baseline (Ps＜0.001). The proportions of patients achieving EASI-50, EASI-75, and EASI-90 were 89.5% , 47.4% , and 2.6% , respectively. Adverse events occurred in 12 patients (31.6%), and serious adverse events (SAE) occurred in 2 patients (5.2%), including 1 case of colorectal malignancy and 1 case of cardiovascular event (coronary heart disease). Conclusion: Abrocitinib demonstrates robust short-term efficacy in elderly patients  with moderate-to-severe AD in a real-world context. While the safety profile is generally manageable, the occurrence of SAEs, including malignancy and cardiovascular events, underscores the need for rigorous risk-benefit assessment and enhanced safety monitoring in this specific population, particularly given their underlying comorbidities and age-related risks.

Key words: atopic dermatitis, abrocitinib, real-world study, elderly, JAK inhibitor