Most Read Articles
14 Sep 2020
Osteoarthritis (OA) is the most common condition affecting the joints. Dr Lee Eu Jin, an Orthopaedic Surgeon from Liberty Orthopaedic Clinic at Mount Elizabeth Medical Centre, Singapore, shares his insights with Pearl Toh on how to manage OA in the primary care setting.


27 Sep 2019
Quadrivalent influenza vaccine (split virion, inactivated) 0.5 mL inj
Stephen Padilla, 27 May 2020
Use of oral fluconazole in the first trimester does not lead to oral clefts or conotruncal malformations but is associated with musculoskeletal malformations, a study has shown.
Stephen Padilla, 17 Dec 2019
The use of aspirin for primary prevention in patients without known cardiovascular diseases (CVDs) significantly reduces the risk of myocardial infarction (MI) but increases that of major bleeding and haemorrhagic stroke, according to a meta-analysis.

Abrocitinib holds promise for moderate-to-severe AD

Audrey Abella
30 Sep 2020

The investigational JAK1* selective inhibitor abrocitinib was effective and well-tolerated in adolescents and adults with moderate-to-severe atopic dermatitis (AD), the phase III JADE MONO-2 trial has shown.

AD affects children, adolescents, and adults, and greatly impairs quality of life (QoL). [Ann Allergy Asthma Immunol 2018;121:340-347; J Am Acad Dermatol 2018;79:448-456.e30] Patients who fail to respond to topical remedies are usually managed with systemic therapy; however, adverse events (AEs) often confound long-term use. [J Eur Acad Dermatol Venereol 2018;32:850-878]

Moreover, the use of the approved AD drug dupilumab is limited by inadequate response, patients’ intolerability to injections, and AEs. [Br J Dermatol 2019;181:459-473; Biologics 2019;13:79-82] “Hence, additional treatments … are needed,” said the researchers.

The team randomized 391 participants (mean age 35 years, 59 percent male) 2:2:1 to receive oral abrocitinib 100 or 200 mg QD or placebo for 12 weeks. [JAMA Dermatol 2020;156:863-873]

At week 12, significantly more abrocitinib 100- and 200-mg vs placebo recipients achieved IGA** (28 percent and 38 percent vs 9 percent), EASI-75*** (44 percent and 61 percent vs 10 percent), and PP-NRS# responses (45 percent and 55 percent vs 12 percent; p<0.001 for all).

 

Well-tolerated, better QoL

Despite the high treatment-emergent adverse event (TEAE) rates with abrocitinib 100 and 200 mg (n=99 and 102), discontinuation rates due to AEs were low (n=6 and 5), as were serious infection (n=3 and 0) and serious AE rates (n=5 and 2). Eczema herpeticum/Kaposi varicelliform eruption TEAEs were observed with abrocitinib 100 mg (n=2). Herpes zoster TEAEs occurred with abrocitinib 200 mg (n=2), which resolved even without treatment.

Week 12 saw greater improvements in DLQI## (−8.3 and −9.8 vs −3.9) and Children’s DLQI scores (−4.8 and −9.7 vs −2.7) with abrocitinib 100 and 200 mg vs placebo.

Both abrocitinib 100 and 200 mg also yielded greater reductions in PSAAD### vs placebo (−2.4 and −3.0 vs −0.8), which as per the researchers, could explain the substantial QoL benefits observed. “Abrocitinib may mediate this effect through various mechanisms, including relief of inflammation and/or direct inhibition of neuronal JAK1 signalling of pruritogenic cytokines.”

 

Confirming JADE MONO-1

The results validate the findings of the JADE MONO-1 trial. [Lancet 2020;396:255-266] “[Both studies showed that] IGA and EASI-75 responses were observed [with abrocitinib] as early as week 2 of treatment and were sustained until week 12,” said the researchers.

Also, the current trial included more Asian patients than JADE MONO-1 (33 percent vs 15 percent), who apparently have different subsets of helper T cell-driven inflammatory activity vs patients of European descent. [J Allergy Clin Immunol 2015;136:1254-1264] “[As such,] both trials support the efficacy and safety profile of abrocitinib in a broad range of patients, possibly related to the inhibition of a range of AD-associated cytokines,” they added.

Larger and longer trials are warranted to determine the long-term efficacy and safety of abrocitinib, as “more patients [may achieve] IGA and/or EASI-75 responses with longer treatment,” they said. Future trials should also take into account subsets of patients that were not well-represented in the current trial (eg, adolescents, non-whites) to ascertain generalizability of the findings. The potential of abrocitinib in combination therapy should also be explored in future studies.

 

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Most Read Articles
14 Sep 2020
Osteoarthritis (OA) is the most common condition affecting the joints. Dr Lee Eu Jin, an Orthopaedic Surgeon from Liberty Orthopaedic Clinic at Mount Elizabeth Medical Centre, Singapore, shares his insights with Pearl Toh on how to manage OA in the primary care setting.


27 Sep 2019
Quadrivalent influenza vaccine (split virion, inactivated) 0.5 mL inj
Stephen Padilla, 27 May 2020
Use of oral fluconazole in the first trimester does not lead to oral clefts or conotruncal malformations but is associated with musculoskeletal malformations, a study has shown.
Stephen Padilla, 17 Dec 2019
The use of aspirin for primary prevention in patients without known cardiovascular diseases (CVDs) significantly reduces the risk of myocardial infarction (MI) but increases that of major bleeding and haemorrhagic stroke, according to a meta-analysis.