Abrocitinib for atopic dermatitis: a step forward

Abstract

Atopic dermatitis is one of the most common chronic inflammatory skin diseases worldwide with a global annual prevalence of 3–4%. 1 Weidinger S Beck LA Bieber T Kabashima K Irvine AD Atopic dermatitis. Nat Rev Dis Primers. 2018; 4: 1 Crossref PubMed Scopus (214) Google Scholar Few data are available on disease activity strata, but in a 2018 multinational survey between 10% and 20% of adults with incident atopic dermatitis reported severe disease. 2 Barbarot S Auziere S Gadkari A et al. Epidemiology of atopic dermatitis in adults: results from an international survey. Allergy. 2018; 73: 1284-1293 Crossref PubMed Scopus (332) Google Scholar Atopic dermatitis pathophysiology is characterised by epidermal dysfunction and T-cell-driven inflammation, with increased production of inflammatory cytokines, in particular type 2 cytokines such as interleukin (IL)-4, IL-13, and IL-31. 3 Heratizadeh A Haufe E Stolzl D et al. Baseline characteristics, disease severity and treatment history of patients with atopic dermatitis included in the German AD Registry TREATgermany. J Eur Acad Dermatol Venereol. 2019; (published Nov 13.)https://doi.org/10.1111/jdv.16078 PubMed Google Scholar Type 2 inflammation is also considered the main driver of atopic comorbidities such as asthma and rhinitis, which coexist in up to two-thirds of patients with moderate to severe atopic dermatitis. 4 Strowd LC Feldman SR Dupilumab for atopic dermatitis. Lancet. 2017; 389: 2265-2266 Summary Full Text Full Text PDF PubMed Scopus (8) Google Scholar However, increasing evidence suggests that atopic dermatitis is not dominated by one pathway but rather involves multiple alternating immune pathways. 1 Weidinger S Beck LA Bieber T Kabashima K Irvine AD Atopic dermatitis. Nat Rev Dis Primers. 2018; 4: 1 Crossref PubMed Scopus (214) Google Scholar Efficacy and safety of abrocitinib in adults and adolescents with moderate-to-severe atopic dermatitis (JADE MONO-1): a multicentre, double-blind, randomised, placebo-controlled, phase 3 trialMonotherapy with oral abrocitinib once daily was effective and well tolerated in adolescents and adults with moderate-to-severe atopic dermatitis. Full-Text PDF