Expanding Your Options: A Novel Topical Treatment for Atopic Dermatitis


Atopic dermatitis (AD) is a chronic, debilitating disease that affects 10%–20% of children and 5%–10% of adults.¹ While topical therapies, including corticosteroids and calcineurin inhibitors, remain the standard of care for most patients, tolerability or patient hesitancy may limit their use.¹⁻² What if there was a new therapy you could turn to to help your dermatology practice thrive?


There’s no denying that topical corticosteroids (TCS) are an effective treatment option for AD.² However, their clinical utility may be limited by local adverse events (AE), including:²

· skin atrophy,

· striae,

· purpura,

· telangiectasia,

· focal hypertrichosis,

· and acneiform or rosacea-like eruptions.


TCS potency and treatment duration may also be restricted when treating sensitive areas, such as the face, neck, and skin folds. While topical calcineurin inhibitors (TCI) can be a viable alternative for these delicate areas, patients may report application site stinging and burning.² In cases where neither TCS nor TCI are tolerated, your topical product options are very limited.


To add to this, you’ve probably seen growing concern among patients with steroid phobia, amplified by online communities centered around topical steroid addiction and withdrawal.³ You’re not alone in this observation. Research suggests that up to 84% of patients with AD, and their caregivers, experience steroid phobia, often leading to treatment non-adherence.⁴ Thus, the need for effective, nonsteroidal topical therapy remains.


Incyte’s Opzelura (ruxolitinib) 1.5% cream could be just what you’ve been waiting for. This newly-approved topical offers a highly effective, well-tolerated, nonsteroidal option that targets AD-associated inflammation and pruritus head on.¹


Opzelura is indicated for short-term treatment of mild to moderate AD in non-immunocompromised patients 12 years and older, where other prescription topicals are ineffective or inadvisable. This first-in-class topical JAK inhibitor is applied twice daily to affected areas on up to 20% body surface area.⁵


Opzelura offers a multimodal approach to target key AD pathogenic processes by:

· inhibiting inflammation-associated cytokine signaling,¹

· alleviating chronic pruritus by acting directly on sensory neurons,⁶ and

· enhancing skin barrier function by regulating epidermal protein expression.¹


Opzelura offers results you’ll be excited to share with your patients. During two identically designed trials, over half (up to 54%) of patients treated with Opzelura saw clear or almost clear skin by week eight, compared with a maximum of 15% of patients receiving placebo.¹


Significant itch relief was also achieved among AD study participants. By week eight, over half (up to 52%) of patients treated with Opzelura achieved clinically significant reductions in pruritis, versus up to 16% of those in the placebo group.¹ What’s more, Opzelura takes effect rapidly. Your patients should expect relief as soon as three days after starting treatment.⁷


Opzelura’s excellent safety profile makes it a treatment you can feel good about recommending, especially for patients who have struggled to tolerate AD treatment in the past.


Application site burning is Opzelura’s most common AE, occurring more frequently in subjects taking a placebo (4%) than Opzelura (<1%). Serious treatment-emergent AEs are also rare (0.6% and 0.8% of patients in the Opzelura and placebo groups, respectively), none of which are directly related to Opzelura treatment.¹


Reassuringly, Opzelura is a safe option for sensitive skin areas. Opzelura is well-tolerated on all lesions, including those on the face.¹ Your AD patients will also appreciate Opzelura’s non-greasy, cream formulation, especially in cases where visible locations require treatment.


Given Opzelura’s rapid onset of itch relief and favorable side effect profile, it’s not surprising that discontinuation rates are low. More patients receiving a placebo (3%) discontinue therapy due to treatment-emergent AEs than Opzelura (<1%).¹


What about long-term safety? This research is still ongoing. However, initial results show that Opzelura has relatively low bioavailability when applied topically.¹ During short-term use, no clinically meaningful changes in hematologic parameters are observed, indicating an improved safety profile compared to oral JAK inhibitors, which can cause bone marrow suppression.¹ Still, Opzelura should be avoided in any of your patients with an active, serious infection, or who take:⁵

· therapeutic biologics,

· other JAK inhibitors, or

· potent immunosuppressants (e.g., azathioprine, cyclosporine).


Opzelura is a novel, highly effective, and safe treatment for your AD patients who haven't been responding well to traditional topical therapies. To learn more about incorporating Opzelura into your practice, visit the Opzelura HCP siteand get your patients the relief they've been waiting for.


References

1. Papp K, Szepietowski JC, Kircik L, et al. Efficacy and safety of ruxolitinib cream for the treatment of atopic dermatitis: Results from 2 phase 3, randomized, double-blind studies. J Am Acad Dermatol. 2021;85(4):863-872. doi:10.1016/j.jaad.2021.04.085

2. Eichenfield LF, Tom WL, Berger TG, et al. Guidelines of care for the management of atopic dermatitis: Section 2. Management and treatment of atopic dermatitis with topical therapies. J Am Acad Dermatol. 2014;71(1):116-132. doi:10.1016/j.jaad.2014.03.023

3. Tan SY, Chandran NS, Choi ECE. Steroid Phobia: Is There a Basis? A Review of Topical Steroid Safety, Addiction and Withdrawal. Clin Drug Investig. 2021;41(10):835-842. doi:10.1007/s40261-021-01072-z

4. Li AW, Yin ES, Antaya RJ. Topical Corticosteroid Phobia in Atopic Dermatitis: A Systematic Review. JAMA Dermatol. 2017;153(10):1036-1042. doi:10.1001/jamadermatol.2017.2437

5. Opzelura [Package Insert]. Wilmington, DE: Incyte.; 2021.

6. Kim BS, Howell MD, Sun K, et al. Treatment of atopic dermatitis with ruxolitinib cream (JAK1/JAK2 inhibitor) or triamcinolone cream. J Allergy Clin Immunol. 2020;145(2):572-582. doi:10.1016/j.jaci.2019.08.042

7. Incyte. OPZELURATM (ruxolitinib) cream 1.5% | Itch Results. Accessed January 25, 2022. https://www.opzelurahcp.com/itch-results