Managing Pruritus in Atopic Dermatitis with Ruxolitinib Cream

Pruritus, commonly known as itching, is a distressing symptom often experienced by dermatitis patients. Dermatitis is an inflammatory skin condition characterized by redness, rash, and irritation. The persistent itch can lead to scratching, exacerbating the skin's inflammation. This cycle of scratching and inflammation can worsen the condition and lead to skin damage. Treatment options for pruritus in dermatitis patients include topical corticosteroids, antihistamines, and moisturizers to alleviate symptoms. Identifying triggers, such as allergens or irritants, is crucial for effective management. Patients should refrain from scratching, maintain good skincare practices, and seek medical advice to minimize discomfort and improve their quality of life.

Clinical Trial

Ruxolitinib cream is a topical medication containing ruxolitinib, an inhibitor of Janus kinases 1 and 2 (JAK1/JAK2). A clinical trial investigated the effects of ruxolitinib cream on itch in patients with atopic dermatitis (AD), a skin condition known for its intense itching and inflammation.

The research involved two phase 3 trials, TRuE-AD1 and TRuE-AD2, which enrolled 1249 patients aged 12 years and above, suffering from AD for at least two years, with an Investigator's Global Assessment score of 2 or 3, and 3%-20% of the body surface affected. The participants were randomly assigned to apply 0.75% ruxolitinib cream, 1.5% ruxolitinib cream, or a vehicle cream twice daily for eight weeks in a double-blinded treatment.

Results

The severity of the itch was measured using the numerical rating scale (NRS). The results showed that significantly more patients using ruxolitinib cream achieved a ≥2-point reduction in itch (NRS2) within approximately 12 hours compared to those using the vehicle cream. The improvement continued throughout the eight-week treatment period.

Moreover, a ≥4-point itch reduction (NRS4) was achieved by significantly more patients using 0.75% and 1.5% ruxolitinib cream compared to the vehicle by Day 2. In Week 8, the rates were even higher. The median time for the ruxolitinib cream groups to achieve NRS4 from baseline was 15.0 and 13.0 days for 0.75% and 1.5% strengths, respectively. However, the vehicle group did not reach this endpoint within the study duration.

Conclusion

Ruxolitinib cream demonstrated rapid and sustained improvement in itch for patients with mild to moderate AD. More patients applying ruxolitinib cream experienced significant itch reduction within 12 hours and by Day 2 compared to those using the vehicle cream. This study highlights the potential of ruxolitinib cream as a promising treatment for the bothersome pruritus experienced by AD patients.
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