Abrocitinib may be ‘promising treatment’ for prurigo nodularis, chronic pruritus
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Key takeaways:
- By week 12, itch and pain scores decreased 78.3% and 53.7% in the prurigo nodular and chronic pruritus of unknown origins groups, respectively.
- No serious adverse events were reported.
Abrocitinib may be an effective and well-tolerated treatment for adults with prurigo nodularis and chronic pruritus of unknown origins, according to a study.
“Prurigo nodularis (PN) and chronic pruritus of unknown origins (CPUO) are two of the most difficult forms of itch to treat with limited therapeutics,” Shawn G. Kwatra, MD, professor and chair of dermatology at University of Maryland School of Medicine, told Healio. “In our lab we have worked on immunophenotyping these diseases in humans, which served as our rationale for conducting this proof-of-concept study.”
The phase 2 study, led by Kwatra, evaluated the efficacy and safety of once-daily, 200 mg oral abrocitinib, a Janus kinase (JAK) 1 inhibitor, in adults with moderate to severe PN (n = 10; 10 women; mean age, 58.6 years) or CPUO (n = 10; two women; mean age, 70.7 years). All patients completed 12 weeks of treatment, and 18 also completed the 4-week follow-up period.
Prior to treatment, patients in both the PN and CPUO cohorts exhibited high mean Peak Pruritus Numerical Rating Scale (PP-NRS) scores of 9.2 and 8.2, respectively. After 12 weeks of treatment with abrocitinib, PP-NRS scores decreased 78.3% (95% CI, –118.5 to –38.1) in the PN cohort and 53.7% (95% CI, –98.8 to –8.6) in the CPUO cohort.
By the end of the study, a 4-point improvement on the PP-NRS scale was achieved by eight patients with PN and six patients with CPUO. Quality of life measures were also significantly improved from baseline with patients with PN reporting a 53.2% (95% CI, –75.3% to –31.1%) average decrease in their DLQI scores. Those with CPUO reported similar results with an average decrease of 49% (95% CI, –89.6% to –8%).
Additionally, sleep outcomes, as measured by the Sleep Disturbance Numerical Rating Scale, significantly improved from baseline. Six patients in the PN group achieved a 4 point or higher reduction in their scores, and three patients in the CPUO group achieved the same.
The most common adverse event was acneiform eruption, which occurred in two of the patients. No serious adverse events were reported.
“The speed and depth of itch improvement in both conditions was surprising,” Kwatra told Healio. “While future phase 3 trials are needed to confirm these findings, oral JAK1 inhibition represents a promising treatment approach in patients with prurigo nodularis and chronic pruritus of unknown origin.”
Editor's note: On June 12, the author's title was corrected to reflect his new position at the University of Maryland School of Medicine. The editors regret the error.
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