Induction abrocitinib may prevent flare in moderate, severe atopic dermatitis

Induction therapy with abrocitinib was associated with low flare rates in patients with moderate to severe atopic dermatitis, according to a study.

“The heterogeneous course of moderate to severe atopic dermatitis necessitates treatment flexibility,” Andrew Blauvelt, MD, MBA, of the Oregon Medical Research Center, and colleagues wrote.

In the multicenter, randomized, responder-enriched, double-blinded, placebo-controlled phase 3 JADE REGIMEN study, the researchers looked at maintenance of abrocitinib-induced response to three regimens in a cohort of 1,233 patients (median age, 28 years; 75.5% white).

From that initial group, they culled 798 who had responded to abrocitinib induction therapy at 200 mg for 12 weeks. Those patients were assigned blinded abrocitinib 200 mg, abrocitinib 100 mg or placebo for 40 weeks.

The proportion of patients who experienced a flare served as the primary outcome measure.

For patients who experienced a flare, a rescue treatment regimen of abrocitinib 200 mg and topical therapy was administered.

Results from final follow-up showed flare probability rates of 18.9% for abrocitinib 200 mg, 42.6% for the 100 mg dose and 80.9% for placebo.

Among patients who flared, rescue treatment yielded Investigator Global Assessment scores of 0/1 in 36.6% of patients in the 200 mg dose arm, 58.8% of those in the 100 mg dose arm and 81.6% of those in the placebo arm. Also in the flare group, the rescue regimen led to Eczema Area and Severity Index response of 75% or greater improvement in 55% of patients in the abrocitinib 200 mg group, 74.5% of those in the 100 mg group and 91.8% of those in the placebo group.

Time to flare was a median of 28 days (95% CI, 28-29) in the placebo arm, according to Kaplan-Meier analysis. Time to flare was not reached in either of the abrocitinib treatment arms.

Safety data showed that 63.2% of patients treated with abrocitinib 200 mg and 54% of those treated with the 100 mg dose experienced adverse events.

The researchers noted that the definition of flare was not established, which may reduce the ability to generalize the findings.

“Induction treatment with abrocitinib was effective,” they wrote. “Most responders continuing abrocitinib did not flare. Rescue treatment with abrocitinib plus topical therapy effectively recaptured response.”