Abstract

Atopicdermatitis (AD), a chronic, highly pruritic skin disorder, impairs quality of life (QoL). Janus kinase inhibitors suppress inflammatory and pruritus-associated cytokine signaling in AD. To report the effects of ruxolitinib (RUX) cream on itch and QoL in AD. A total of 307 adult patients with an Investigator's Global Assessment (score of 2 or 3) and 3% to 20% affected body surface area were randomly assigned for 8weeks to receive double-blind treatment with RUX (1.5% twice daily, 1.5% once daily, 0.5% once daily, or 0.15% once daily), vehicle twice daily, or triamcinolone cream (0.1% twice daily for 4weeks then vehicle for 4weeks). Itch was measured by using the numerical rating scale, and patient QoL was assessed with Skindex-16. Improvements in itch numerical rating scale and Skindex-16 were observed with RUX cream. Overall, 42.5% of patients who applied 1.5% RUX twice daily experienced minimal clinically important difference in itch within 36hours of treatment (vehicle, 13.6%; P<.01); near-maximal improvement was observed by week 4. Itch reduction was associated with improved QoL burden (Pearson correlation, 0.67; P<.001). Significant improvements in Skindex-16 overall scores were noted at week 2. Facial AD lesions were not treated. RUX cream provides a clinically meaningful reduction in itch and QoL burden.

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