Abrocitinib Shows Efficacy in Alleviating Itch, Enhancing Quality of Life for Patients with Atopic Dermatitis

Abrocitinib, an oral jak-1 inhibitor approved for treating moderate-to-severe atopic dermatitis (AD), shows to be effective in patients with itch-dominant AD, displaying rapid, deep and steady improvements in itch and quality of life, according to a new study published on Wiley Online Library.

Patients with AD often experience different degrees of itch and lesions, with some expressing more severity than others.

Itch-dominant AD, which is a more severe itch, is common but often challenging to manage. While the extent and severity of skin lesions can cause a burden in AD, itch severity also impacts patients' quality of life, sleep and mental health.

The Burden of AD website also highlights itch as a major challenge in AD. A study the site shares noted 380 patients with moderate to severe AD found that 86% experienced itch daily, 63% endured itch for at least 12 hours daily, and 61% described the itch as severe or unbearable.

Also a challenge, is the association between itch and the severity of lesions, as it isn’t clear with patients experiencing more itch than visible lesions, according to the study.

For example, scoring systems commonly used to measure the severity might undervalue the seriousness of the condition, especially in folks with darker skin tones, resulting in differences between how patients report their condition and how physicians assess it.

Though the drug has shown efficacy in moderate-to-severe AD, researchers of the study aimed to evaluate abrocitinib efficacy in patients with moderate-to-severe AD who have itch-dominant AD.

In a comprehensive post-hoc analysis, researchers of the study examined data from clinical trials investigating abrocitinib in AD, both as monotherapy and in combination with topical therapy.

Researchers included data from trials such as JADE MONO-1, JADE MONO-2 and JADE COMPARE, as well as the ongoing long-term JADE EXTEND trial, with itch-dominant AD as the focus.

Findings revealed that a large portion of patients, approximately 37%, had itch-dominant AD at the start of the trials.

As soon as week 2, data revealed notable improvements in itch severity among patients receiving abrocitinib compared to those on placebo.

By week 12, a higher proportion of patients treated with abrocitinib achieved clear or almost clear skin compared to the placebo group. Abrocitinib also demonstrated enhancements in patient-reported outcomes, including quality of life measures.

Over the course of the trials, most patients with itch-dominant AD experienced consistent improvements in itch severity and skin lesions with either abrocitinib monotherapy or combined with topical therapy.

By weeks 24 and 48, a majority of patients reported either no itch or only a mild itch, accompanied by clear or moderately affected skin.

While the findings highlight the efficacy of abrocitinib in addressing itch-dominant AD and improving overall disease burden in this population, limitations of the study do exist.

For example, the JADE trials focused on moderate to severe AD, excluding patients with mild lesions, potentially limiting complete representation of itch-dominant AD. It also remains unclear if participants had chronic itch-dominant AD.

In addition, as the JADE EXTEND study is still ongoing, some patients never reached week 48, making results incomplete as of April 22, 2020.

In this post hoc analysis, abrocitinib has shown rapid improvement in itch and quality of life. Researchers suggest that longer-term data will refine abrocitinib's efficacy profile, crucial for treating itch-dominant AD amidst evolving therapies.