In which type of patient do you recommend a JAK inhibitor as first-line systemic therapy (biologic-naive) with moderate-to-severe atopic dermatitis?

A JAKi is almost never my first-line systemic therapy for AD. I generally reach for biologics targeting IL4/13 first and move to JAKi if those are ineffective or not tolerated. The main scenario where I would choose a JAKi first would be someone who had needle phobia or refused biologics.