Real-world Experience of Abrocitinib Treatment in Patients with Atopic Dermatitis and Hand Eczema: Up to 28-week Results from the BioDay Registry

Abstract

Limited daily practice data on the effect of abrocitinib in patients with atopic dermatitis are available. The aim of this multicentre prospective study is to evaluate the effectiveness and safety of abrocitinib in patients with atopic dermatitis treated in daily practice. In a subgroup, the effectiveness of abrocitinib on hand eczema was evaluated. A total of 103 patients from the BioDay registry were included in the study: week 4 (n = 95), week 16 (n = 61) and week 28 (n = 39). At week 28, the Eczema Area and Severity Index (EASI)-50/75/90 was achieved by 81.8%, 57.6%, and 18.2%, respectively, and the weekly average pruritus numerical rating scale ≤ 4 by 62.9%. The effectiveness of abrocitinib was not significantly different between dupilumab non-responders and dupilumab-naïve patients/responders, and between upadacitinib non-responders and upadacitinib-naïve patients/responders. Mean ± standard deviation Hand Eczema Severity Index decreased from 27.4 ± 27.7 at baseline to 7.7 ± 12.1 at week 28 (n = 31). Thirty-two patients (31.1%) discontinued treatment due to ineffectiveness (n = 17), adverse events (n = 9) or both (n = 3). The most frequently reported adverse event was nausea (n = 28). In conclusion, abrocitinib is an effective treatment for atopic dermatitis and can be effective for patients with previous inadequate response to dupilumab or upadacitinib. Furthermore, hand eczema can improve in patients treated with abrocitinib for atopic dermatitis.

Biologics Versus JAK Inhibitors. Part I: Cancer Risk. A Narrative Review

“…We found nine studies on the risk of neoplasms with selective JAK 1 (JAK-1) inhibitors: three focusing on abrocitinib [ 77 , 99 , 100 ] and six on upadacitinib [ 55 , 101 – 105 ]. In the three studies with abrocitinib, including 787 patients with AD, no cases of cancer were reported [ 77 , 99 , 100 ].…”

“…We found nine studies on the risk of neoplasms with selective JAK 1 (JAK-1) inhibitors: three focusing on abrocitinib [ 77 , 99 , 100 ] and six on upadacitinib [ 55 , 101 – 105 ]. In the three studies with abrocitinib, including 787 patients with AD, no cases of cancer were reported [ 77 , 99 , 100 ]. Regarding upadacitinib, a recent SR including 25 RCTs (> 10,000 patients) reported that most of the RCTs did not find a significant increase in the rate of malignancies with upadacitinib therapy when compared to placebo or to anti-TNFs [ 101 , 103 , 105 ].…”

Real-world Experience of Abrocitinib on Difficult-to-treat Hand Eczema in Chinese Patients

“…Sitaru et al ( 10 ) reported a case of refractory hand and foot eczema was successfully treated with abrocitinib. Kamphuis et al ( 11 ) demonstrated that abrocitinib improved HE in patients with AD in which 13/17 of the patients achieved clear or almost clear and 60% of the patients achieved HECSI 90 at week 16. In our study, all patients reached HECSI 90 and 9/12 of the patients achieved an IGA score of 0/1 at week 16.…”

“…It blocks IL-4, IL-13, IL-31, and IFN-γ pathways, which are involved in the pathogenesis of HE ( 9 ). However, the efficacy of abrocitinib on difficult-to-treat HE in real-world is limited ( 10 , 11 ). Here, we reported the effectiveness and safety of abrocitinib on difficult-to-treat HE patients in daily practice.…”