JAK1 Inhibitor Improves Atopic Dermatitis Symptoms, Even in Nonresponders

Participants with atopic dermatitis who did not achieve Investigator’s Global Assessment (IGA) 0 or 1 response in a trio of 12-week trials nevertheless showed meaningful improvement in measures of disease severity and quality of life, according to study findings published in the Journal of Dermatological Treatment.

“The IGA does not directly measure improvements in %BSA [percentage of body surface area] affected, sleep loss, itch, or overall quality of life,” researchers wrote. “In addition, the criterion for response (0 [clear] or 1 [almost clear] with ≥2-grade improvement) is considered a high threshold, especially when patients enrolled in clinical trials have often failed multiple systemic therapies.”

For the study, researchers analyzed data from three phase 2b/3 trials of abrocitinib monotherapy in patients with moderate-to-severe atopic dermatitis. The pooled analysis included 548 IGA nonresponders.

Compared with placebo, nonresponders treated with abrocitinib showed rapid and clinically meaningful improvement in skin clearance, itch, and quality of life, researchers reported. This included gains in Eczema Area and Severity Index-50 and -75 response, as well as improved scores on the Peak Pruritus Numerical Rating Scale and the sleep loss subscale of SCORing Atopic Dermatitis (SCORAD).

Improvements in signs and symptoms of atopic dermatitis subsequently led to improvements in quality of life as gauged by the Dermatology Life Quality Index, according to the study.

“The limitations of IGA are evident from the current analyses,” researchers wrote, “which suggest that IGA nonresponders receiving abrocitinib achieve meaningful reductions in other clinical measures of atopic dermatitis disease severity and improvement in quality of life vs placebo.”

Pfizer Inc sponsored the investigation. 

Reference:
Blauvelt A, Boguniewicz M, Brunner PM, et al. Abrocitinib monotherapy in Investigator's Global Assessment nonresponders: improvement in signs and symptoms of atopic dermatitis and quality of life. J Dermatolog Treat. Published online ahead of print July 6, 2022. doi:10.1080/09546634.2022.2059053