Latest Research Hot Spots of Atopic Dermatitis Management Using Janus Kinase Inhibitor: A Bibliometric Analysis and Visualized Review

Introduction

Atopic dermatitis (AD), commonly known as eczema, is a chronic, relapsing inflammatory skin disorder that affects 11% to 20% of children and 5% to 8% of adults globally. The impact of AD can be substantial, particularly for those with moderate to severe forms of the disease; around one-third of affected children and half of adults experience significant symptoms that necessitate systemic therapy when conventional topical treatments and phototherapy prove insufficient.^1–3

The clinical presentation of AD is characterized by intense pruritus, eczematous lesions associated with T-helper cell type (TH) 2 and TH22 inflammation, and dry skin due to epidermal barrier dysfunction. These symptoms can severely disrupt daily activities for both patients and their caregivers. The pathogenesis of AD is multifactorial, involving skin barrier defects, immune dysregulation, allergies, and interactions with the microbiome and environment, all contributing to persistent skin inflammation.^3–5

While conventional therapies such as topical corticosteroids, calcineurin inhibitors, and systemic immunosuppressants remain standard, their limitations highlight the urgent need for more targeted and durable treatments.^6–9

In recent years, the landscape of AD management has been transformed by the introduction of targeted systemic treatments. Dupilumab, a fully humanized monoclonal antibody that inhibits IL-4 and IL-13 signalling, represents a significant advancement, being the first non-corticosteroid approved for moderate to severe AD. Despite its efficacy and favorable safety profile, the variability in patient responses underscores the necessity for additional systemic options.^6,10 However, despite these advances, important research gaps remain. Bibliometric analysis offers a systematic way to map research activity, identify influential contributors, and highlight emerging therapeutic strategies.

One promising avenue for treating AD is Janus kinase (JAK) inhibition, which plays a critical role in Th2 cytokine signalling. Several JAK inhibitors, including baricitinib, upadacitinib, abrocitinib, and ruxolitinib, are currently FDA approved for this condition.¹¹ While previous studies have demonstrated the comparative safety and efficacy of dupilumab versus JAK inhibitors for AD [Tsai et al, JACI 2024], relatively few studies have focused specifically on JAK inhibitors. Bibliometric analysis helps to address this gap.¹²

To understand the rapidly evolving landscape of JAK inhibitor research in AD, bibliometric analysis offers a valuable approach. This quantitative method allows for mapping of key contributors, institutional impact, collaboration networks, and emerging trends within the literature. This study presents a bibliometric and visualized review of global research hotspots on JAK inhibitors in the context of AD management.

Materials and Methods

Search Strategies and Data Acquisitions

Publications were retrieved from the Web of Science Core Collection (WOSCC) database using the search terms: (Janus kinase inhibitors OR JAK) AND (atopic dermatitis). WOSCC was selected because it offers comprehensive citation data and is the most widely used database for bibliometric analysis, providing consistent export formats compatible with VOSviewer. Scopus and PubMed were not used as they lack comparable citation linkage or compatibility for network mapping.

The search was conducted on November 1, 2024, and covered publications from the past 10 years, spanning from January 1, 2014, to January 1, 2024. Initially, 797 publications were identified. After excluding 37 non-English articles and 93 with inappropriate methodology, the final dataset consisted of 776 articles and reviews. The retrieved studies were analyzed and visualized using VOSviewer, Excel, and Drawio software.

Bibliometric Analysis

In our study, we began by exporting the full records of all retrieved results in plain text (TXT) format from the Web of Science platform. This was followed by a comprehensive analysis using a range of advanced bibliometric tools, including VOSviewer (version 1.6.17), Microsoft Excel (2019), and Draw.io. First, we calculated key metrics such as Publications, percentages, citations, citation per publications and total link strength in association with countries, institutions, funding agencies, co-cited journals, co-cited authors, cited references and related keywords. To gain deeper insights into the research landscape, we created network visualization maps for countries, institutions, co-cited journals, co-cited authors, funding agencies and co-cited references using VOSviewer. This analysis allowed us to identify emerging trends, key evolutionary paths, and pivotal turning points within the field.

Results

An Overall Literature Findings

The literature on Janus kinase inhibitors in atopic dermatitis has grown steadily over the past decade. From 2014 to 2024, a total of 797 publications were identified from the Web of Science database. These included 667 (83.69%) original research articles and review articles, while 130 (16.31%) publications were excluded based on predefined criteria: 37 (4.64%) were non-English, and 93 (11.67%) had inappropriate methodologies. For a detailed illustration of the characteristics of desired publications, see Figure 1 (flowchart of the search and screening process). The included studies spanned a timeframe of 10 years, focusing on the use of Janus kinase inhibitors in the management of atopic dermatitis. The annual publication output demonstrated consistent growth over the decade, with detailed trends analyzed in Figure 2, highlighting increased scholarly interest especially in the last five years. All eligible studies were published between January 1, 2014, and January 1, 2024, and were examined using bibliometric tools such as VOSviewer (version 1.6.17), Excel (2019), and Draw.io. This analysis sheds light on the expanding research interest in JAK inhibitors, highlighting global research hotspots and advancements in this promising therapeutic area for atopic dermatitis management.

Figure 1 Flowchart of The Search Strategy.

Figure 2 Graphical distribution of global publications on JAKi in atopic dermatitis. The map illustrates the number of articles produced by each country from 2014 to 2024. Darker shading indicates higher output, with the United States leading (272 publications), followed by Germany (36), Japan (28), and Canada (60). This visualization highlights the concentration of research activity in North America, Europe, and East Asia.

The Regional Distribution of Global Publications Output

To identify global research trends, we analyzed the geographic distribution of publications and international collaborations. Publications were distributed among 49 different countries and regions. Figure 2 highlights the global distribution of the top ten contributing countries. In recent years, the USA has shown the largest growth in publication numbers, followed by Germany, Japan, and China. Table 1 ranks the top countries based on the volume of publications. As shown in Table 1, the US accounted for the largest share of publications (34%), followed by Germany, Japan, and China. Denmark had the highest citations per publication (70.55), highlighting its impact despite a smaller volume. This indicates that North America, Europe, and East Asia are the most active regions in JAK inhibitor research for atopic dermatitis. Figure 3 provides an analysis of international research collaborations. From this data, ten clusters were identified. The US emerged as a significant leader in global research partnerships, as shown by its publication count (272), total citations (11,383), average citations per publication (41.84), and total link strength (7217). Denmark had the highest citations per publication, with a value of 70.55. Although countries like Germany, Japan, Canada, Italy, and France had fewer publications than the USA, their contributions remained substantial, underscoring their vital role in global research collaboration—particularly with the USA, as reflected by strong link strengths in co-authorship networks.

Table 1 Top Ten Productive Countries

Figure 3 Network visualization map of international research collaborations on Janus kinase inhibitors in atopic dermatitis. Each node represents a country, with node size proportional to the number of publications. Lines between nodes represent collaboration strength; thicker lines indicate more frequent co-authorship. Colors represent clusters of countries that collaborate more closely with each other. The US, Germany, Japan, and China emerged as central hubs of global collaboration.

Analysis of Institutional Output

Table 2 shows that US institutions dominate publication output, with Mount Sinai and Oregon Health & Science University leading. Kyoto University, however, stood out with the highest citation impact (82.57 per publication). Notably, the majority of these leading institutions are based in the United States, highlighting the country’s significant academic influence in this field. In contrast, Kyoto University in Japan stands out with the highest citations per publication at 82.57, suggesting that it produces a substantial number of high-quality publications and plays a vital role in advancing the field. Figure 4 illustrates the collaborative network analysis among these institutions. A total of 89 institutions were included in the literature review, each contributing a minimum of five articles. The analysis was conducted using VOSviewer.

Table 2 Top Ten Productive Institutions

Figure 4 Network visualization map of the most productive institutions contributing to research on Janus kinase inhibitors in atopic dermatitis. Each node represents an institution, with node size proportional to publication output. Links between nodes indicate collaborative relationships, where thicker lines represent stronger collaboration intensity. Colors denote distinct clusters of institutions that frequently co-publish, highlighting leading centers such as Mount Sinai, Oregon Health & Science University, and Kyoto University.

Analysis of Journals and Co-Cited Journals

The ten most productive and co-cited journals are listed in Table 3. A total of 60 journals published the relevant publications, of which three journals published more than 20 publications. In total, 176 publications were published in the top ten active journals. Journal of Dermatological Treatment (26 publications, 6.15%) published the most research in this field, followed by Journal of the European Academy of Dermatology and Venereology (25 publication, 5.91%), and The Journal of Allergy and Clinical Immunology (20 publications, 4.73%). Among the top ten most productive journals, The Journal of Dermatological Treatment had the highest IF (3230) in 2021, and JAMA Dermatology had the highest number of citations per publication (0.71%). Additionally, more than half of the top ten productive journals were classified in Q1.

Table 3 Top Ten Productive and Co-Cited Journals

The co-citation network further emphasizes journal influence. As shown in Figure 5, journals cluster into groups based on citation patterns. Journal productivity is also visualized in Figure 5A, while citation influence is illustrated in Figure 5B. The most frequently co-cited journal was The Journal of Allergy and Clinical Immunology (3078 citation, TLS: 238306). The next most frequently co-cited journals were Journal of the American Academy of Dermatology (3042 citation, TLS: 225755) and British Journal of Dermatology (2233 citation, TLS: 182545), showing that they were all valuable information resources. Among the top ten co-cited journals, The New England Journal of Medicine had the highest IF (176) in 2021 with the highest H-index (1184). More than half of the top ten co-cited journals were Q1.

Figure 5 Network visualization maps of co-cited journals in research on Janus kinase inhibitors for atopic dermatitis. (A) Publications per journal. (B) Co-cited journals by citation influence.

Analysis of Funding Agencies

Based on the acknowledgement data, the top funding organizations supporting research on JAK inhibitors for atopic dermatitis over the past decade have been identified. The Ministry of Education, Culture, Sports, Science, and Technology (MEXT) of Japan supported 27 publications, while the Japan Society for the Promotion of Science (JSPS) and the National Natural Science Foundation of China (NSFC) each funded 24 studies. Grants-in-Aid for Scientific Research (KAKENHI) contributed to 21 publications. In the United States, the National Institutes of Health (NIH) and the Department of Health and Human Services funded 20 studies each. This funding distribution highlights the considerable contributions of governmental agencies with major support coming from Japan, the United States, and China. Table 4 summarizes the contributions of the top 10 funding agencies.

Table 4 Top Ten Funding Agencies

Analysis of References

The network of co-cited references is shown in Figure 6. The size of the node represents the number of specific publications that have been cited. The more the literature is cited, the larger the diameter of the node.

Figure 6 Co-cited references in JAK inhibitor research for atopic dermatitis. Foundational works such as Oetjen (2017) and Wollenberg (2018) appear as the largest nodes, reflecting their central influence within distinct thematic clusters.

Table 5 summarizes the top 35 most-cited references according to the number of citations, including author, title, and year of publication. From Table 5, “Oetjen (2017)” is the most highly cited, with 674 citations and a link strength of 49, marking it as a foundational work in this field. Following closely are influential works by “Wollenberg (2018)” with 393 citations and “Damsky (2017)” with 313 citations, each playing a significant role in shaping research directions. “Bissonnette (2016)” has a link strength of 77, the highest in this table, suggesting it plays a critical role in linking different research areas or themes. This could mean that Bissonnette’s work bridges multiple subfields or methodologies, making it a central node in the co-citation network. Remarkably, authors such as “Guttman-Yassky” and “Simpson” appear multiple times, reflecting their sustained impact and repeated contributions.

Table 5 35 Most Cited References

Analysis of Keywords and Keyword Co-Occurrence Clusters

In 797 publications, a total of 1088 keywords were mentioned. The analysis focused on 83 items that appeared at least five times (co-occurrence > 5). Figure 7 Illustrates the network analysis map of keyword co-occurrence, featuring 83 items, 922 links and six clusters.

Figure 7 Keyword co-occurrence clusters. “Atopic dermatitis” dominates the network, while terms such as “upadacitinib”, “baricitinib”, and “abrocitinib” appear as emerging hotspots, reflecting current research trends.

Each item is represented by a node, the node’s size indicates how frequently the keyword appears in the topic articles. The thickness of the lines connecting two nodes reflects the frequency with which those keywords occur together in the topic articles, with thicker lines meaning a greater co-occurrence of the keywords.

According to Table 6, the most frequently used key- words are “atopic dermatitis”, “jak inhibitors”, “upadacitinib”, “baricitinib”, “eczema”, “janus kinase inhibitors”, “jak inhibitor”, “dupilumab”, “biologics”, “psoriasis”.

Table 6 Top Ten Related Keywords

“Atopic dermatitis” is the largest theme (Cluster 1, 322 occurrence, TLS:869), followed by “jak inhibitors” (Cluster 2, 63 occurrence, TLS:221), “upadacitinib” (Cluster 3, 62 occurrence, TLS:204), “baricitinib” (Cluster 4, 49 occurrence, TLS:187), “eczema” (Cluster 5, 48 occurrence, TLS:191), “janus kinase inhibitors” (Cluster 6, 48 occurrence, TLS:152), “jak inhibitor” (Cluster 7, 47 occurrence, TLS:148), “dupilumab” (Cluster 8, 46 occurrence, TLS:158), “biologics” (Cluster 9, 40 occurrence, TLS:122), “psoriasis” (Cluster 10, 39 occurrence, TLS:135).

Discussion

Atopic Dermatitis (AD) is a chronic inflammatory disease that is defined by a group of characteristics, which include itching, dryness, and skin lesions. Its management involves a group of treatments which include topical treatments, systemic treatments, and lifestyle modifications.^1,2 In recent years, janus kinase inhibitors (JAK) have emerged as an effective treatment for severe atopic dermatitis, these oral medications work by inhibiting specific enzymes involved in the inflammatory process, helping to reduce symptoms and flare-ups, This bibliometric study aims to review the latest research hot spots of Atopic Dermatitis management using JAK.^1–3

The Most-Contributing Authors and the Most-Cited Papers

From 2014 to 2024, The number of publications on the usage of JAK in the treatment of atopic dermatitis has significantly increased, a total number of 667 studies were analyzed in this bibliometric study after implementing exclusion criteria, the USA has shown the largest growth in publication numbers, leading at 272 publications. “The Journal of Dermatological Treatment” published the most research in this field, Accounting for 26 publications. It is the most productive resource for the usage of JAK in the treatment of Atopic Dermatitis (AD), The most co-cited journal was “The Journal of Allergy and Clinical Immunology” sitting at a total of 3078 Citations. This indicates that the journal is highly influential and relevant to the topic. Furthermore, “The Journal of the American Academy of Dermatology”. “British Journal of Dermatology”, and “The New England Journal of Medicine”, were also the major journals in the field discussing the topic. “The New England Journal of Medicine” Showed the highest IF (176) in 2021 with the highest H-index (1184), it indicates the credibility of the journal.

Emma Guttman-Yassky ranks as the top author, with a significant number of publications (25 articles, 1739 citations) and an average citation rate of 14.45% citations per publication, Followed by Eric L. Simpson (22 Publications), Thomas Bieber (19 Publications), The most Co-Cited article of the top author, “Two Phase 3 trials of dupilumab versus placebo in atopic dermatitis”, explored a two identically designed Phase 3 studies in patients with atopic dermatitis have shown that dupilumab improves the signs and symptoms of atopic dermatitis, including pruritus, symptoms of anxiety and depression, and quality of life compared with placebo.^13,14,16,37

Neurons Co-opt Classical Immune Signaling Pathways to Mediate Chronic Itch article highlights the critical role of Type 2 cytokines in directly activating sensory neurons in both mouse and human models. Specifically, interleukin-4 (IL-4) enhances neuronal responsiveness to multiple pruritogens, while the sensory neuron-specific deletion of IL-4 receptor alpha (IL-4Ra) or JAK1 significantly reduces chronic itch. Clinical studies further demonstrate that JAK inhibitors provide effective relief for chronic itch, underscoring the importance of targeting this pathway for therapeutic intervention.¹⁶ Consensus-based European guidelines for treatment of (AD) in adults and children: part I and II discuss the initial success of topical JAK inhibitors, particularly tofacitinib, which demonstrated promising results in Phase II clinical trials. Despite its efficacy, the topical development program was halted. However, similar compounds are under investigation for both topical and systemic therapy. Currently, no JAK inhibitors are licensed for use in Europe, though they hold significant potential in dermatology.^14,15 JAK inhibitors in dermatology: The promise of a new drug class article emphasizes the efficacy of JAK inhibitors across a range of inflammatory dermatoses, including atopic dermatitis, alopecia areata, psoriasis, and vitiligo. He notes that the JAK-STAT signaling pathway is central to the pathophysiology of these conditions. With numerous ongoing clinical trials, JAK inhibitors are poised to have broad applicability in dermatology, offering innovative treatment options for various inflammatory skin diseases.¹³ Biomarkers in atopic dermatitis-a review on behalf of the International Eczema Council article explores the role of biomarkers in AD management, particularly their potential to facilitate precision medicine approaches for this heterogeneous condition. The study highlights CCL17/TARC as the most robust biomarker for correlating with disease severity and treatment response. However, it also notes that a single biomarker cannot fully capture the complexity of AD. The conclusion calls for further research to validate reliable biomarkers, integrate them into clinical practice, and enhance personalized care and therapeutic development.³⁷ Topical tofacitinib for atopic dermatitis: a phase IIa randomized trial provides valuable insights into AD treatments with novel mechanisms of action. The findings demonstrate that tofacitinib ointment shows significantly greater efficacy compared to placebo across all endpoints, with an early onset of effect and comparable safety and tolerability. These results suggest that JAK inhibition via topical delivery is a promising treatment target for AD.⁴⁵

Figure 7 illustrates the timing analysis of keyword co-occurrence in atopic dermatitis. Recent trending keywords with high frequency are closer to yellow color. The analysis indicates that current trending research on atopic dermatitis are centered around Upadacitinib, Abroocitinib, Methotrexate, Safety, Biologics, Jak inhibitors, Barictinib. A randomized control study published by Guttman-Yassky et al,¹⁷ compared the efficacy of Upadacitinib Vs placebo in patients with AD. Upadacitinib, at both 15 mg and 30 mg doses, is much more effective than a placebo in treating moderate-to-severe AD in adults and adolescents, according to the findings of the Measure Up 1 and Measure Up 2 studies. As for Abrocitinib, a randomized control trial demonstrated that higher doses of Abrocitinib (200 mg and 100 mg) significantly improved clinical outcomes and reduced pruritus compared to placebo.²⁴ Furthermore, methotrexate has proven to be an effective treatment for moderate to severe AD with a study involving 41 patients demonstrating significant improvement in symptoms. Patients experienced a mean improvement noted within 4 to 6 weeks, with 93% achieving over 75% improvement by the 24-week mark.²⁹ Moreover, a paper published by Damsky titled “JAK inhibitors in dermatology: the promise of a new drug class” explained the mechanism of action of JAK inhibitors in managing different dermatological conditions. Oral tofacitinib reduced the Severity Scoring of AD Index by 66.6% and the pruritus and sleep loss by 69.9% in a case study of six patients who had failed all common therapies. In addition, a Phase 2a randomized placebo-controlled, double-blind trial showed that after four weeks, 2% tofacitinib ointment treatment reduced the eczema area dns severity index score by 81.7%, and on the other hand, the placebo group had a 29.9% reduction.¹³ For adults with AD, Baricitinib is a promising oral treatment as It acts as a JAK1 and JAK2 inhibitor and has shown as 2 mg and 4 mg doses efficacy in improving disease severity, quality of life, and pruritus.^18,28,46

The study utilized a large database, web of science (WOS), yielding a dataset of 776 articles, however, the exclusion of non-english publications and studies may omit relevant research published. Moreover, the rapid nature of AD treatments might mean that findings may become outdated as new therapies emerge.

Conclusion

Janus Kinase (JAK) inhibitors have become the prominent treatment for severe atopic dermatitis (AD). Obtaining a comprehensive understanding of the latest hotspots of the management of AD using JAK inhibitors is essential. Our study offers a broad overview of the principal research directions in this field, emphasizing the contributions of the USA, as well as its affiliated institutions and authors. Prominent journals in this field include Journal of Dermatological Treatment, Journal of the European Academy of Dermatology and Venereology, and The Journal of Allergy and Clinical Immunology. The most cited paper was “Oetjen (2017)” where the most frequently used key- word was “atopic dermatitis”. Finally, this study provides novel insights that can facilitate further research in this field. Findings from bibliometric studies should be interpreted cautiously, as results may be influenced by English-only indexing and country-level publication practices. Nevertheless, identifying active regions and collaborations provides useful guidance for clinicians and researchers.