Efficacy and safety of abrocitinib in patients with moderate‐to‐severe atopic dermatitis and comorbid allergies

• Published in: Allergy (Copenhagen) 2024-01, Vol.79 (1), p.174-183
• Main Authors: Schmid‐Grendelmeier, Peter, Gooderham, Melinda J., Hartmann, Karin, Konstantinou, George N., Fellmann, Marc, Koulias, Christopher, Clibborn, Claire, Biswas, Pinaki, Brunner, Patrick M.
• Format: Article
• Language: English
• Subjects: abrocitinib; Allergies; Asthma; Atopic dermatitis; Clinical trials; Comorbidity; Conjunctivitis; Dermatitis; Dermatitis, Atopic - complications; Dermatitis, Atopic - diagnosis; Dermatitis, Atopic - drug therapy; Double-Blind Method; Eczema; Food allergies; food allergy; Humans; Immunoglobulin A; Placebos; Pruritus; Quality of life; Rhinitis; Safety; Severity of Illness Index; Treatment Outcome
• ISSN: 0105-4538; 1398-9995; 1398-9995
• DOI: 10.1111/all.15952

Background Abrocitinib efficacy by comorbidity status in patients with moderate‐to‐severe atopic dermatitis (AD) has not been previously assessed. This post hoc analysis evaluated the efficacy and safety of abrocitinib in patients with AD and allergic comorbidities. Methods Data were pooled from patients who received abrocitinib 200 mg, 100 mg, or placebo in phase 2b (NCT02780167) and phase 3 (NCT03349060, NCT03575871) monotherapy trials. Patients with and without allergic comorbidities (allergic asthma, rhinitis, conjunctivitis, or food allergy) were evaluated for Investigator's Global Assessment (IGA) response (clear [0] or almost clear [1]), ≥75% improvement in the Eczema Area and Severity Index (EASI‐75), ≥4‐point improvement in Peak Pruritus Numerical Rating Scale (PP‐NRS4), and Dermatology Life Quality Index (DLQI) response (1 allergic comorbidity, 34%). Regardless of comorbidity status, from Week 2 to Week 12, higher percentages of patients treated with either abrocitinib dose achieved IGA 0/1, EASI‐75, PP‐NRS4, or DLQI 0/1 versus placebo‐treated patients. Changes from baseline in POEM, SCORAD, and PSAAD were greater with abrocitinib than with placebo in patients with and without allergic comorbidities. Most TEAEs were mild or moderate. Conclusions Efficacy and safety data support abrocitinib use to manage AD in patients with or without allergic comorbidities. In this pool of patients with moderate‐to‐severe AD, 53% reported at least one allergic comorbidity (asthma, conjunctivitis, rhinitis, or food allergies). Abrocitinib 200 mg or 100 mg monotherapy improved clinical, patient‐reported, and HRQoL outcomes versus placebo, regardless of patients' allergic comorbidities. In patients with moderate‐to‐severe AD, abrocitinib is efficacious and well tolerated in those with or without allergic comorbidities.