By Joe Gorelick, MSN, FNP-C
Abrocitinib (Cibinqo, Pfizer) effectively and safely manages itch in prurigo nodularis (PN) and chronic pruritus (CP) of unknown origin, new data suggest. Researchers assessed the effect of treatment on 20 patients (10 with PN and 10 with CP) over 12 weeks.
At a dose of 200mg once a day for 12 weeks, abrocitinib was found to reduce itching and pain symptoms by 78% in PN patients. Patients with chronic pruritus of unknown origin experienced a 54% reduction in itching and pain symptoms. Patients in both groups also reported an improvement in their quality of life and in their sleep habits. Findings appear in JAMA Dermatology.
None of the patients experienced serious adverse events. The most common side effect was development of small acne-like bumps in about 10% of subjects.
The study was not blinded or placebo-controlled.
Previous studies have shown itch reduction associated with different JAK inhibitors. In the HEADS UP trial of upadacitinib (Rinvoq, AbbVie) 30mg once daily compared to dupilumab (Dupixent, Sanofi Regeneron) 300mg every other week, subjects receiving upadacitinib had a 31 percent reduction in itch (as measured by Worst Pruritus Numerical Rating Scale [NRS]) at the end of week one, compared to 9 percent in the comparator group.
By inhibiting the JAK pathway, small molecule therapy with JAK inhibitors may quickly and effectively reduce the symptom of itch. Data show that reduction of itch related to JAK inhibition occurs rapidly, in some cases as early as two days.
Taken together, these data suggest there may be a clear benefit in small molecule JAK inhibition to address itch related to AD and other diseases. The importance of adequately and effectively reducing itch as the primary symptom of AD cannot be understated.
Pfizer, Inc., provided funding and study drug for the abrocitinib study. Study co-author Shawn Kwatra, MD, the Joseph W. Burnett Endowed Professor and Chair of Dermatology at University of Maryland School of Medicine and Chief of Service Dermatology at the University of Maryland Medical Center, previously served as a paid consultant for Pfizer and is also funded by the National Institutes of Health.