An evaluation of abrocitinib for moderate-to-severe atopic dermatitis

Expert Rev Clin Immunol. 2022 Nov;18(11):1107-1118. doi: 10.1080/1744666X.2022.2126353. Epub 2022 Sep 29.

Abstract

Introduction: Atopic dermatitis (AD) is a common itchy inflammatory skin condition that affects many individuals. For many years, the landscape of AD treatment remained unchanged; however, there has been developing therapies that directly target the underlying immunological mechanism of AD. Janus kinase (JAK) inhibitors are small molecules that have shown anti-inflammatory and anti-itch effects in AD. Recently, abrocitinib, an oral JAK 1 inhibitor, was approved by the Food and Drug Administration for atopic dermatitis.

Areas covered: By downregulating the immune cascade, abrocitinib has demonstrated the ability to curb symptoms of AD, including rapidly reducing pruritus in 2-3 days, and is safe and well-tolerated overall despite a low increased risk in infection. The data discussed was obtained from a comprehensive literature review utilizing PubMed.

Expert opinion: Abrocitinib has strong efficacy, likely due to its broader mechanism of action provided by the inhibition of key regulatory molecule, JAK. Results have demonstrated that it is more efficacious at curbing symptoms of AD than dupilumab, the current treatment of choice for refractory, moderate-to-severe AD. While abrocitinib provides a great alternative treatment, particularly for non-responders and AD subtypes, it also demonstrates a stronger side effect profile that must be considered.

Keywords: Abrocitinib; JAK inhibitor; atopic dermatitis; eczema; small molecules.

Publication types

  • Review

MeSH terms

  • Dermatitis, Atopic* / chemically induced
  • Humans
  • Janus Kinase Inhibitors* / therapeutic use
  • Janus Kinases
  • Pyrimidines / adverse effects
  • Pyrimidines / therapeutic use
  • Severity of Illness Index
  • Sulfonamides / therapeutic use

Substances

  • abrocitinib
  • Pyrimidines
  • Sulfonamides
  • Janus Kinase Inhibitors
  • Janus Kinases