Topical ruxolitinib 1.5% (JAK1/JAK2 inhibitor) improves clinical and patient‐reported outcomes in moderate to severe chronic hand dermatitis: Data from a small open‐label trial

Abstract

BackgroundChronic hand dermatitis (CHD) has suboptimal treatments and a negative impact on quality of life (QoL). Topical ruxolitinib, a JAK1/JAK2 inhibitor, is approved for vitiligo and mild‐to‐moderate atopic dermatitis, but has not previously been studied specifically for CHD.ObjectivesEvaluate the impact of ruxolitinib in CHD.MethodsA 12‐week, investigator‐initiated, open‐label trial evaluated ruxolitinib 1.5% in 15 adults with recalcitrant moderate‐to‐severe CHD. Primary outcomes included the proportion of patients: (1) achieving an Investigator Global Assessment (IGA) treatment success (0 or 1 score with a two‐step improvement) (2) a Hand Eczema Severity Index (HECSI)‐75 improvement at 12 weeks. Additional outcomes: clinical improvement at 4 and 8 weeks, improvement in itch (Numerical Rating Scale [NRS]) and QoL outcomes (i.e., Dermatology Life Quality Index [DLQI] and Skindex‐Mini).ResultsAt 12 weeks, 13/15 participants (86%) achieved a HECSI‐75, 12/15 participants (80%) had a two‐point reduction in IGA and 8/15 participants (53%) achieved an IGA treatment success. Both atopic dermatitis (AD; n = 7) and non‐AD (n = 8) CHD participants had clinical improvement in HECSI at 12 weeks (p < 0.01). 10/12 participants with baseline NRS ≥ 2 (83%) achieved a ≥ 2 point reduction on average itch at 12 weeks. 9/10 with baseline NRS ≥ 4 (90%) achieved a ≥4‐point itch reduction by 4 and 12 weeks. A significant decline in self‐reported daily itch (average and worst) was observed within the first week of treatment (p < 0.001). By CHD subtype, AD‐CHD had greater itch at baseline compared to non‐AD CHD (p < 0.01), consequently itch reduction was greater in AD‐subtype. Improvement in QoL (DLQI, Skindex‐Mini) was achieved at 4 weeks maintained to 12 weeks (p < 0.01). No treatment‐related adverse events were reported during the study and no rescue medications were used.ConclusionsRuxolitinib may be a promising treatment for CHD, improving clinical outcomes, itch and QoL. Significant improvement was achieved at 4 weeks and maintained through 12 weeks of treatment.