The Promise of Topical Ruxolitinib for Atopic Disease Management

On the heels of several new Food and Drug Administration (FDA) approvals and promising data from ongoing trials regarding ruxolitinib, HCPLive spoke with 2 key investigators on the first and only topical formulation of a JAK inhibitor currently approved in the United States.

Returning to discuss the approval of ruxolitinib cream for the treatment of mild to moderate atopic dermatitis, Lawrence Eichenfield, MD, of the Rady Children’s Hospital and UC San Diego School of Medicine, cited the success of the topical cream in the TRuE-AD clinical trial programs.

Recent data showed that higher strength ruxolitinib cream applied twice a day over 8 weeks resulted in roughly half (51%-54%) of all participants reporting clear or almost clear skin.

Secondary measures such as EASI 50 and EASI 75 were also “incredibly impressive”, said Eichenfield.

Though the labeling of topical ruxolitinib presented a new discussion point between clinicians and patients with atopic disease, highlighting the complexities of oral JAL inhibitors, Eichenfield spoke of promise of the topical cream for other immune-mediated diseases,

“So, the vitiligo stuff is very exciting, because it's a disease that's been neglected and (it’s an) incredibly common disease, (and) early efficacy data using ruxolitinib for vitilogo seems incredibly positive,” Eichenfield said.

David Rosmarin, MD, Vice Chair of Research and Education, Dermatology Department at Tufts Medical Center, spoke to some of the positive data regarding topical ruxolitinib and vitiligo.

Rosmarin participated in a recent 24-week trial that evaluated the efficacy of ruxolitinib in patients with vitiligo.

The data was presented at the European Academy of Dermatology and Venereology (EADV) 30th Congress.

“Currently, there's not a single medicine that is FDA approved to help re-pigment patients with vitiligo,” Rosmarin said. “This study was the largest one ever done in a randomized controlled study, and it helps prove that using ruxolitinib cream can help re-pigment patients with vitiligo both on the face as well as the body.”

Data from the TRuE-V program reported that 29.9% of patients who applied ruxolitinib cream achieved ≥75% improvement from baseline in the facial Vitiligo Area Scoring Index (F-VASI75) at week 24 of the trial.

Additionally, more than 51% of patients achieved ≥50% improvement from baseline in F-VASI (F-VASI50), and more than 15% of patients applying ruxolitinib cream achieved ≥90% improvement from baseline in F-VASI (F-VASI90).

In his interview, Rosmarin had already considered how topical ruxolitinib could be used in tandem with other methods such as phototherapy in the treatment of vitiligo patients.

“So, the study that was done in the TRuE-V1 and TRuE-V2 was just ruxolitinib pre- monotherapy, and ruxolitinib alone was able to have a significant impact,” Rosmarin said. “However, perhaps in combination (with phototherapy), it can help patients even more so and do it more rapidly.”

To hear more from both Dr. Eichenfield and Dr. Rosmarin, watch the videos above.