Eczema drug may relieve intensely itchy skin diseases

A recent study has uncovered promising results for a drug originally approved for eczema, showing significant improvement for patients with severe itching conditions that presently have no targeted treatments. The drug, abrocitinib, demonstrated minimal side effects in a small 12-week trial, proving beneficial for individuals with prurigo nodularis and chronic pruritus of unknown origin, conditions characterized by relentless itching.

The research, published in JAMA Dermatology and led by the University of Maryland School of Medicine (UMSOM), found that abrocitinib effectively alleviated symptoms in patients suffering from these distressing conditions. According to Shawn Kwatra, MD, the Joseph W. Burnett Endowed Professor and Chair of Dermatology at UMSOM and Chief of Service Dermatology at the University of Maryland Medical Center (UMMC), the study was inspired by his laboratory's findings on the role of inflammatory mediators influencing these conditions through the JAK1 pathway. Dr. Kwatra emphasized the potential of this research to advance personalized therapies that could offer sustainable relief for individuals grappling with these debilitating diseases.

Prurigo nodularis, which affects at least 130,000 Americans, manifests as numerous itchy and disfiguring bumps predominantly on the chest, arms, and legs. Dr. Kwatra's earlier studies show that prurigo nodularis is more prevalent in Black patients than in white patients, is more common in women, and is linked with conditions such as depression, diabetes, chronic kidney disease, and HIV. Chronic pruritus of unknown origin, primarily affecting older adults, results in severe itching that lasts beyond six weeks. Current treatments, including over-the-counter and prescription itch relief ointments and anti-inflammatory drugs like antihistamines and corticosteroids, often fail to provide long-term relief.

The study included 20 patients, split evenly between those with prurigo nodularis and those with chronic pruritus of unknown origin. Each participant received a daily 200-milligram dose of abrocitinib for 12 weeks. The absence of a placebo group meant that all patients were aware they were receiving an experimental treatment. Results showed a remarkable 78 percent reduction in itching and pain symptoms for prurigo nodularis patients, while those with chronic pruritus of unknown origin experienced a 54 percent reduction. Participants across both groups also reported enhanced quality of life and improved sleep patterns.

No serious adverse events were reported during the trial. The most common side effect was the development of small acne-like bumps, affecting 10 percent of the patients.

Abrocitinib is a JAK1 inhibitor that suppresses inflammation by targeting pro-inflammatory cytokines involved in overactive immune responses. By hindering the intracellular signaling of these cytokines, the drug helps reduce immune system activity.

Mark T. Gladwin, MD, the John Z. and Akiko K. Bowers Distinguished Professor and Dean of UMSOM, and Vice President for Medical Affairs at the University of Maryland, Baltimore, lauded the study's findings. He highlighted its potential to pave the way for a Phase 3 clinical trial, which could introduce a novel treatment to patients, particularly in underserved communities disproportionately affected by prurigo nodularis—a condition that has historically been neglected in dermatology.

Since assuming his role at UMSOM, Dr. Kwatra has established the Maryland Itch Center at UMMC, where he continues his groundbreaking research on these itching diseases.