Abrocitinib Working as a Rescue Therapy for Atopic Dermatitis

Jonathan Silverberg, MD

Abrocitinib resulted in a recaptured response for a large proportion of patients with atopic dermatitis suffering from flares.

A team, led by Jonathan Silverberg, George Washington University, evaluated the efficacy of abrocitinib as a rescue therapy in data presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting (AAAAI) 2022.

JADE REGIMEN

In the JADE REGIMEN trial, investigators examined the efficacy of abrocitinib-induced responses with continual, reduced dose, or withdrawal of the treatment in patients with moderate-to-severe atopic dermatitis.

The investigators selected a patient population who flared during the maintenance period to receive abrocitinib rescue treatment.

Responders to abrocitinib 200 mg, defined by the Investigator’s Global Assessment (IGA) 0/1 with at least a 2 grade improvement and 75% improvement in Eczema Area and Severity Index (EASI-75), were randomly assigned to either abrocitinib 200 mg, abrocitinib 100 mg, or placebo for 40 weeks.

Patients who flared during the maintenance period, defined as at least a 50% loss of week-12 EASI response and at least 2 IGA grades, were offered rescue therapy of abrocitinib 200 mg and topical corticosteroids or calcineurin inhibitors for 12 additional weeks.

The investigators evaluated responses defined as recaptured IGA, EASI, or Peak Pruritus Numerical Rating Scale (PP-NRS) as scores not worse than randomization baseline responses.

The Patients

The investigators enrolled 16.2% (n = 43) of the abrocitinib 200 mg cohort, 39.2% (n = 104) of the abrocitinib 100 mg group, and 76.4% (n = 204) of the placebo arm into the rescue study following protocol-defined flares.

The results show at week 12 the proportion of patients recapturing IGA response was 35.7% (95% CI, 21.2-50.2%), 50.5% (95% CI, 40.8-60.1%), and 74.0% (95% CI, 67.8-80.1%), respectively.

For EASI response, it was 33.3% (95% CI, 19.1-47.6%), 32.0% (95% CI, 23.0-41.1%), and 57.1% (95% CI, 50.2-64.1%) and for PP-NRS response it was 28.6% (95% CI, 9.2-47.9%), 39.7% (95% CI, 27.1-52.2%), and 68.2% (95% CI, 58.5-77.9%) for the abrocitinib 200 mg, 100 mg, and placebo arms, respectively.

“Rescue therapy with abrocitinib 200 mg plus topical medicated therapy recaptured response in patients who flared during the maintenance period of JADE REGIMEN,” the authors wrote.

The study, “Efficacy of Abrocitinib Rescue Therapy in the Phase 3 Study JADE REGIMEN,” was published online by the Journal of Allergy and Clinical Immunology.