313 Evaluating the effectiveness of topical tofacitinib in reducing non-atopic dermatitis chronic itch

Abstract

Introduction: Chronic and refractory pruritus is a highly common complaint amongst patients with dermatological conditions and remains difficult to treat with current drug therapies. There is an unmet need for potent topical antipruritics. Janus kinase (JAK) inhibitors have shown significant effect in treating atopic eczema itch. Objective: Topical tofacitinib compounding cream was investigated for treatment of non-AD related chronic pruritic diseases. Methods: A comprehensive chart review was completed where data was collected on numerous variables that help recognize the efficacy of tofacitinib. 19 patients with chronic itch of different types (excluding those with AD) treated with topical tofacitinib 2% compounding cream within the last four years were identified and evaluated regarding their demographic information, diagnosis, location and characteristics of itch, itch intensity scale ratings, adverse effects and reasons for discontinuation (if applicable). Paired-sample t-test was performed to evaluate average 24-hour itch intensity scale ratings prior to and after initiating topical tofacitinib. Results: 13 (68%) out of 19 patients demonstrated a quantifiable reduction in itch. Average 24-hour itch scale ratings decreased significantly (p<0.001) after initiation of tofacitinib from 7.82 (± 2.23) to 4.47 (± 3.55) across all patients, with score reduction of 3.34 (± 3.34). Tofacitinib was effective for many causes of non-AD itch, particularly in patients with prurigo nodularis and psoriasiform dermatitis. Overall, the drug was safe with no major adverse effects; the main reason for discontinuation of the drug was no relief or short duration of relief time after application. Conclusion: Topical tofacitinib cream significantly decreased the average itch intensity of patients and is generally well-tolerated, making it a promising therapeutic for non-AD related chronic itch.