Abrocitinib (Cibinqo, Pfizer) improves the symptoms of prurigo nodularis and chronic pruritus of unknown origin, according to a new study in JAMA Dermatology.
The 12-week study involved 20 patients, half of whom had prurigo nodularis and half of whom had chronic pruritus of unknown origin. They were all given a 200-milligram pill of abrocitinib once a day for 12 weeks. Patients knew they were being given an experimental treatment, and the study did not include a placebo group. Abrocitinib was found to reduce itching and pain symptoms by 78% in the prurigo nodularis patients. Patients with chronic pruritus of unknown origin experienced a 54% reduction in itching and pain symptoms. Patients in both groups also reported an improvement in their quality of life and in their sleep habits.
None of the patients experienced serious adverse events. The most common side effect, in 10% of patients, was small acne-like bumps.
“Very few treatments exist for prurigo nodularis and chronic pruritus of unknown origin; patients often suffer for years in horrible discomfort, which can lead to anxiety and depression, severely impacting their quality of life,” says TDD Editorial Advisory Board member and study author Shawn Kwatra, MD, the Joseph W. Burnett Endowed Professor and Chair of Dermatology at University of Maryland School of Medicine (UMSOM) and Chief of Service Dermatology at the University of Maryland Medical Center (UMMC), in a news release.“The rationale for this study came from my laboratory’s study findings of altered inflammatory mediators in these conditions that all function through JAK1. Through this trial, we hope to continue to move the needle toward personalized therapies that can provide sustainable relief for coping with these debilitating conditions.”
Dr. Kwatra’s previous research indicates that prurigo nodularis occurs more than 3 times as frequently in Black patients than white patients, tends to be more common in women, and is associated with depression, diabetes, chronic kidney disease, and HIV. Chronic pruritus of unknown origin is most prevalent among older adults and causes severe itching lasting longer than six weeks. Current therapies used to help manage symptoms include over-the-counter and prescription itch relief ointments and anti-inflammatory drugs such as antihistamines and corticosteroids. None of these medications, however, provide sustained relief.
“This is not only an encouraging study but also sets the stage for a Phase 3 clinical trial,” adds Mark T. Gladwin, MD, who is the John Z. and Akiko K. Bowers Distinguished Professor and Dean of UMSOM, and Vice President for Medical Affairs at University of Maryland, Baltimore. “It holds promise for introducing a novel treatment to patients in underserved communities disproportionately affected by prurigo nodularis, a condition historically overlooked by dermatology.”
Since beginning his position at UMSOM, Dr. Kwatra has created the Maryland Itch Center at UMMC and is currently continuing his research there.
PHOTO CREDIT: University of Maryland School of Medicine
