Abrocitinib Effective, Well-Tolerated for Prurigo Nodularis and Chronic Pruritus

A recent study has revealed that the Janus kinase 1 inhibitor, abrocitinib, shows promise in treating prurigo nodularis (PN) and chronic pruritus of unknown origin (CPUO). The findings, published online on June 5 in JAMA Dermatology, highlight the drug's effectiveness and safety profile for these conditions.

The research team, led by Dr. Shawn G. Kwatra from the University of Maryland School of Medicine in Baltimore, conducted a phase 2, nonrandomized controlled trial. This study involved 20 adult patients, equally divided between those with moderate-to-severe PN and CPUO. Participants were administered a 200-mg oral dose of abrocitinib daily over a 12-week period. All patients completed the treatment regimen, and 18 of them also completed a four-week follow-up.

Results from the trial indicated a significant reduction in the Peak Pruritus Numerical Rating Scale (PP-NRS) scores by the end of the 12-week period. Specifically, PN patients saw a 78.3 percent decrease, while CPUO patients experienced a 53.7 percent reduction. Moreover, eight out of 10 patients with PN and six out of 10 with CPUO achieved a minimum of a 4-point improvement on the PP-NRS from baseline to week 12.

In addition to the reduction in pruritus, patients also reported substantial improvements in their quality of life. This was evidenced by the percentage change in Dermatology Life Quality Index (DLQI) scores, which decreased by 53.2 percent for PN patients and 49.0 percent for those with CPUO.

The safety profile of abrocitinib was also assessed during the trial. The most frequently observed adverse event was acneiform eruption, occurring in 10 percent of the patients. Importantly, no serious adverse events were reported throughout the study period.

Despite these promising results, the authors of the study emphasize the need for larger, randomized, double-blind, placebo-controlled trials. Such studies would be crucial for validating the current findings, uncovering less common adverse effects, conducting subgroup analyses, and identifying differences in systemic inflammatory markers between responders and non-responders to the treatment.

One of the study's authors disclosed connections to several pharmaceutical companies, including Pfizer, which not only funded the trial but also manufactured and supplied the study drug.

In conclusion, the study provides encouraging evidence that abrocitinib could be an effective and well-tolerated treatment option for patients with PN and CPUO. However, further research is necessary to confirm these findings and to explore the broader implications of this treatment approach.