Objective:

To develop and validate a gene expression profile test for guiding systemic therapy selection in patients with atopic dermatitis.

Key Findings:

• Patients with a JAK inhibitor–responder profile showed higher rates of disease clearance with JAK inhibitors compared to Th2-targeted therapies.
• Outcomes for patients with a Th2 molecular profile were similar regardless of treatment class.
• The assay is noninvasive and positions itself as a companion diagnostic for systemic drug selection.

Interpretation:

Molecular stratification can effectively identify patients who will benefit more from specific treatments, potentially improving clinical outcomes and reducing unnecessary treatment changes.

Limitations:

• Validation was limited to patients aged 12 years and older.
• Newer biologics were underrepresented in the study.

Conclusion:

Gene expression profiling can enhance treatment decisions for atopic dermatitis by aligning therapy with individual molecular profiles, promoting evidence-based clinical practices.