Abrocitinib provides deep and rapid improvement in atopic dermatitis symptoms
Published: September 12, 2022
Atopic dermatitis (AD) is a chronic, inflammatory skin disease characterized by itchy, red, and flaky skin patches that often occur repeatedly over a person’s lifetime. In addition, people with AD often report sleep disturbance, symptoms of anxiety and depression, and diminished quality of life, all of which become worse if the disease increases in severity. Systemic treatments for AD (ie, those not applied to the skin) include injectable proteins, such as dupilumab, which blocks a receptor for interleukin-4, a mediator of inflammation, and orally administered blockers of Janus kinase, another inflammation mediator. In a phase 3 clinical trial (JADE COMPARE), conducted in patients with moderate-to-severe AD, abrocitinib, a Janus kinase blocker, was better than placebo in providing clinically meaningful improvements in signs and symptoms of AD as well as quality of life; it was also better than dupilumab in relieving itch. In patients with moderate-to-severe AD, it is also important to know if patients are able to attain high levels of improvement in the signs and symptoms of their condition.
The goal of this additional analysis of JADE COMPARE data, conducted by Dr Kristian Reich and colleagues and published in The Journal of Allergy and Clinical Immunology: In Practice, was to determine the proportions of adults with moderate-to-severe AD treated with placebo, abrocitinib (100 mg or 200 mg daily), or dupilumab (300 mg every two weeks) who achieved various levels of improvement in the signs and symptoms of AD.
A total of 837 patients received their assigned treatment for 16 weeks. The investigators looked at the proportions of patients in each treatment group who attained various levels of improvement in skin clearance, disease severity, itch, and quality of life, and at the time needed for at least 50% of patients to attain those levels.
This analysis revealed that, at week 16, more patients treated with abrocitinib 200 mg (15%), abrocitinib 100 mg (13%), or dupilumab (6%) achieved clear skin, compared with placebo (5%). More patients treated with abrocitinib (200 mg, 49%; 100 mg, 38%) or dupilumab (39%) achieved 90% or better improvement from baseline in disease severity compared with placebo (11%). These improvements in signs and symptoms of AD were associated with more patients treated with abrocitinib (200 mg, 30%; 100 mg, 22%) or dupilumab (24%) than with placebo (11%) who reported that AD had no effect on their quality of life. Finally, the estimated time for 50% of patients to achieve 90% or better improvement from baseline in disease severity was 59 days for abrocitinib 200 mg, 113 days for abrocitinib 100 mg, or 114 days for dupilumab, and could not be determined for the placebo group. The estimated time for 50% of patients to attain complete or almost complete cessation of itch was 86 days for abrocitinib 200 mg and 116 days for dupilumab, and it could not be evaluated for abrocitinib 100 mg and placebo.
More patients treated with abrocitinib achieved near complete control of AD signs and symptoms compared to those who received placebo.
The Journal of Allergy and Clinical Immunology: In Practice is an official journal of the AAAAI, focusing on practical information for the practicing clinician.