Why Ruxolitinib May Alter Atopic Dermatitis Care Options

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The JAK inhibitor received FDA approval for vitiligo this summer. Investigator now see it as a potent non-steroidal option for eczema.

Ruxolitinib cream 1.5% (Opezlura) was approved by the US Food and Drug Administration (FDA) this July for the treatment of nonsegmental vitiligo—a novel, breakthrough indication for a topical JAK inhibitor in a space with few options.

Incyte’s agent may be next considered for a chronic skin disease with a more robust armamentarium: atopic dermatitis, which itself already has available JAK inhibitors upadacitinb and abrocitinib.

In the final segment of an interview with HCPLive during the 2022 Fall Clinical Dermatology Meeting this week, Peter Lio, MD, clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine, discussed the particular opportunity of treatment strength ruxolitinib may provide relevant to available eczema drugs.

“I think what’s really great about this is it’s the first non-steroidal topical that is roughly at least…on par with the strength of a mid-potency steroidal,” Lio said. “There was one trial where you can see, they had triamcinolone as one of the comparator arms, and topical ruxolitinib held its own or even did better.”

Lio said the JAK inhibitor is “clearly in the same ballpark” as standard-strength steroidal therapy—an exciting prospect given the historical difference between steroidal and non-steroidal potencies. It opens avenues for creative regimen strategies.

“To have a non-steroidal that can potentially take over—even if we’re alternating, staying non-continuous with both,” Lio said. “We can use different agents to treat and not overdo anything or run the risk of side effects more than we have to.”

Regarding the short future of atopic dermatitis, Lio anticipates an even greater embrace of “customizability.”

“There’s just so much heterogeneity in this disease that to meet individual needs, we should have as many options as possible,” he said. “I’d like to have all these options, and again, potentially rotate between them.”

It’s a prospect that gives him and colleagues great hope for their capability in tailoring treatment for right patient.

“This is a virtuous cycle of drug development: we make a new medicine, we learn more about the disease it’s treating from the medicine, then we refine and make better medicines,” Lio said. “I think we’re finding that for atopic dermatitis, so the best is yet to come.”

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