Ruxolitinib is a new medication being studied for the treat of eczema. Ruxolitinib is a selective inhibitor of Janus kinase 1 and Janus kinase 2, it potently suppresses cytokine signaling involved in atopic dermatitis pathogenesis.
We discussed the Janus Kinase pathway in a previous post and how new drugs are being developed for the treatment of eczema for it.
Atopic dermatitis is a common inflammatory skin disorder with an estimated cost of 5.3 billion annually in the U.S. It affects sleep and reduces quality of life. Current treatments remain limited in scope and efficacy.
This is in addition to dupilumab which allergists have been using for sometime now with great success. Janus Kinase inhibitors such as ruxolitinib, inhibit the pathways to directly target diverse pathogenic pathways that underlie atopic dermatitis. A recent study published in JACI report a controlled phase 2b study comparing different concentrations and regimens of the JAK inhibitor ruxolitinib compared to triamcinolone cream which is a well accepted standard topical steroid. The target population were those who have mild to moderate forms of atopic dermatitis. The key findings were:
- Compared with placebo and triamcinolone, topical ruxolitinib induces a rapid improvement of itching.
- Ruxolitinib displays a positive risk benefit ratio.
- 1.5% ruxolitinib cream is clearly more efficacious than placebo and seems to be superior the the triamcinolone cream in overall efficacy.
- The response to ruxolitinib suggests that the therapeutic effects seems to further improve after the 4 week time endpoint.
Another interesting characteristic of JAK inhibition is the fast mode of action with regard to itching. This is likely due to blocking IL-31, IL-4 and IL-13. Overall the cream was well tolerated and did not demonstrate any additional safety concerns in the treatment arms versus vehicle. Ruxolitinib seems to be a promising new and safe alternative for the management of mild to moderate eczema. This study supports the possible addition of ruxolitinib cream to other treatments available for atopic dermatitis. More studies will need to be done in the future to confirm these studies.