A Maximum-Use Trial of Ruxolitinib Cream in Children Aged 2-11 Years with Moderate to Severe Atopic Dermatitis.

IF 8.6 1区 医学 Q1 DERMATOLOGY American Journal of Clinical Dermatology Pub Date : 2025-01-06 DOI:10.1007/s40257-024-00909-5
Linda Stein Gold, Robert Bissonnette, Seth Forman, Andrea Zaenglein, YuTzu Kuo, Brett Angel, Xuejun Chen, Howard Kallender, Amy S Paller
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引用次数: 0

Abstract

Background: Ruxolitinib cream has demonstrated anti-inflammatory and antipruritic activity and was well tolerated in a phase 3 study in patients aged 2-11 years with mild to moderate atopic dermatitis (AD).

Objective: This study examined the safety, tolerability, pharmacokinetics, efficacy, and quality of life (QoL) with ruxolitinib cream under maximum-use conditions and with longer-term use.

Methods: Eligible patients were aged 2-11 years with moderate to severe AD [Investigator's Global Assessment (IGA) score 3-4], and ≥ 35% affected body surface area (BSA). Patients applied 1.5% ruxolitinib cream twice daily to all baseline-identified lesions during the 4-week maximum-use period, then to active lesions only up to week 52 (patients with ≤ 20% affected BSA from week 8). Safety was assessed by frequency and severity of adverse events. Pharmacokinetic parameters were assessed as secondary endpoints, and efficacy and QoL were exploratory endpoints.

Results: Overall, 29 patients (median age 5 years) were enrolled. Treatment-emergent adverse events were reported in 9/29 patients (31.0%); there were no adverse events of special interest (i.e., no serious infections, malignancies, major adverse cardiovascular events, or thromboses) during the study period. Mean steady-state plasma concentration during the maximum-use period was below the known half-maximal inhibitory concentration of Janus kinase-mediated myelosuppression in adults. Reductions in affected BSA and IGA observed at week 4 were sustained with as-needed use through 52 weeks. Improvements in patient-reported outcomes and QoL measures were consistent with efficacy results.

Conclusion: These results support the safety of ruxolitinib cream in children (2-11 years) with AD, including those with extensive disease, and are consistent with previous efficacy findings.

Clinicaltrials:

Gov identifier: NCT05034822, first registered 30 August 2021.

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背景:在一项针对2-11岁轻度至中度特应性皮炎(AD)患者的3期研究中,Ruxolitinib乳膏具有抗炎和止痒活性,且耐受性良好:本研究考察了芦可利替尼乳膏在最大使用量条件下和长期使用时的安全性、耐受性、药代动力学、疗效和生活质量(QoL):符合条件的患者年龄为2-11岁,患有中度至重度AD[研究者总体评估(IGA)评分3-4],受累体表面积(BSA)≥35%。在为期4周的最大使用期内,患者每天两次在所有基线确定的皮损处涂抹1.5%的芦可利替尼乳膏,然后仅在活动皮损处涂抹至第52周(从第8周开始,受影响体表面积≤20%的患者)。安全性根据不良反应的频率和严重程度进行评估。药代动力学参数为次要终点,疗效和 QoL 为探索性终点:共有 29 名患者(中位年龄为 5 岁)入组。9/29例患者(31.0%)报告了治疗突发不良事件;研究期间未发生特别值得关注的不良事件(即未发生严重感染、恶性肿瘤、重大心血管不良事件或血栓)。最大使用期内的平均稳态血浆浓度低于已知的成人 Janus 激酶介导的骨髓抑制的半最大抑制浓度。按需使用该药52周后,第4周观察到的受影响BSA和IGA降低情况得以持续。患者报告的结果和QoL指标的改善与疗效结果一致:这些结果支持芦可利替尼乳膏在儿童(2-11岁)AD患者(包括大面积疾病患者)中的安全性,并且与之前的疗效结果一致:Gov identifier:NCT05034822,2021年8月30日首次注册。
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来源期刊
CiteScore
15.20
自引率
2.70%
发文量
84
审稿时长
>12 weeks
期刊介绍: The American Journal of Clinical Dermatology is dedicated to evidence-based therapy and effective patient management in dermatology. It publishes critical review articles and clinically focused original research covering comprehensive aspects of dermatological conditions. The journal enhances visibility and educational value through features like Key Points summaries, plain language summaries, and various digital elements, ensuring accessibility and depth for a diverse readership.
期刊最新文献
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