Abrocitinib Effective in Atopic Dermatitis Regardless of Allergic Comorbidities

Melinda Gooderham, MD

Recent data on the Janus kinase inhibitor medication abrocitinib showed that the medication had comparable efficacy and safety in patients with and without allergic comorbidities with atopic dermatitis, despite some differences in baseline characteristics.

The findings were presented at the 2021 American College of Allergy, Asthma, and Immunology (ACAAI) Scientific Meeting in New Orleans.

Investigators led by Melinda Gooderham, MD, SkiN Center for Dermatology, Queen’s University and Probity Medical Research, Ontario, Canada, noted multiple controlled studies that detailed the efficacy of abrocitinib, citing it as an effective treatment for moderate-to-severe atopic dermatitis.

However, allergic comorbidities have become common in patients with atopic dermatitis, with some abrocitinib outcomes in patients with the disease sharing underlying immunopathology.

As such, Gooderham and colleagues presented results from the JADE REGIMEN that compared the response to abrocitinib 200 mg and 100 mg, as well as placebo in patients with only atopic dermatitis and patients with the disease and 1 or more allergic comorbidities.

The Methods

Initially, Gooderham and investigators pooled data from 1 phase 2b (NCT02780167) and 2 phase 3 (JADE MONO-1, NCT03349060; JADE MONO-2, NCT03575871) studies.

All patients featured in the studies had moderate-to-severe atopic dermatitis, some of whom had allergic comorbidities that included allergic asthma, food allergies, allergic conjunctivitis, or allergic rhinitis at baseline.

Investigators added that self-reported allergic comorbidities were either previous comorbidities or ongoing and were derived from individual patient’s medical history.

Patients were divided between 2 atopic dermatitis groups, 1 of which incorporated the allergic comorbidities detailed earlier.

From there, the two groups were compared based on Investigator’s Global Assessment (IGA) response of clear (0) or almost clear (1) with a ≥2-point improvement (IGA 0/1), as well as ≥75% improvement in the Eczema Area and Severity Index score (EASI-75) and a ≥4-point improvement in the Peak Pruritus Numerical Rating Scale score.

Dermatology Life Quality Index (DLQI) response of score <2 was also detailed, as was the overall safety of abrocitinib.

The Findings

Investigators reported that out of the total number of patients, 64.7% had met the response threshold (IGA 0/1 with ≥ 2-grade improvement and EASI-75).

Following 12 weeks of induction. 3.2% of sub-threshold responders achieved IGA 0/1, while 39.5% (34.1-44.9) achieved EASI-75, and 70.1% (65.0-75.1) achieved EASI-50. Additionally, 44% of all patients achieved PP-NRS4.

Investigators noted that regardless of comorbidity status, significantly more patients treated with both doses of abrocitinib achieved an IGA 0/1 response at week 12 compared to the placebo group.

The percentage of patients treated with abrocitinib who achieved EASI-75, PP-NRS4, and DLQI responses showed similar trends in both subgroups.

Regarding the safety of abrocitinib, safety events were generally comparable between patients with and without comorbidities, particularly in the placebo and abrocitinib 200-mg groups, the exception being for serious and severe adverse events, which were more common in patients with comorbidities for all treatment arms.

Despite higher disease burden based on IGA, patients in the abrocitinib group showed comparable efficacy and safety in patients with and without allergic comorbidities, despite differences in baseline characteristics.

“The results of this analysis indicate that abrocitinib is both effective and safe for patients with moderate-to-severe AD regardless of the presence of allergic comorbidities,” the team wrote.