Topical JAK and PDE4 inhibitors promising treatments for Atopic dermatitis: Study

China: Topical Janus kinase (JAK) and phosphodiesterase-4 (PDE4) inhibitors are novel treatment approaches for atopic dermatitis (AD).

A new study reported that Topical Janus kinase (JAK) and phosphodiesterase-4 (PDE4) inhibitors were promising treatments for Atopic dermatitis. However  drugs tofacitinib, ruxolitinib, delgocitinib when applied twice a day showed showed superior efficacy over other JAK and PDE4 inhibitors.

This study is published in the Journal of Dermatology. 

An estimated 16.5 million adults are diagnosed with atopic dermatitis (AD), with 6.6 million people meeting the criteria for moderate to severe disease. Topical Janus Kinase and phosphodiesterase-4 inhibitors are novel treatment approaches for atopic dermatitis. Xian Jiang, Department of Dermatology, West China Hospital, Sichuan University, Chengdu, China, and colleagues aimed to compare the efficacy and safety of JAK and PDE4 inhibitors for AD treatment.

The study was a survey of databases of PubMed, EMBASE, Web of Science, and Cochrane Library which were searched until June 2021 for eligible studies of AD patients treated with topical JAK and PDE4 inhibitors. Baseline and follow-up data were extracted. Efficacy of JAK inhibitors was evaluated using Investigator's Global Assessment (IGA) achieving "clear" or "almost clear", with 2 points or more improvement from baseline at the end of treatment, referred to as "IGA response"). A Bayesian multiple treatment network meta-analysis with fixed effects was performed. 

A total of 4689 patients from 10 randomized controlled trials of topical JAK and PDE4 inhibitors were included for analysis.

The results of the study were: 

• A total of three topical JAK inhibitors and two topical PDE4 inhibitors were included. Compared with placebo, all JAK and PDE4 inhibitors had higher IGA responses at 4 weeks of treatment.

• A similar safety profile was seen in tofacitinib 2% b.i.d., ruxolitinib 1.5% b.i.d., and delgocitinib 3% b.i.d. showed favorable IGA response compared with topical tacrolimus and corticosteroids.

• Ranking analysis suggested that among all included JAK and PDE4 inhibitors, tofacitinib 2% b.i.d. had the highest probability of achieving IGA response of SUCRA = 0.880.

• Besides, JAK and PDE4 inhibitors showed a non-inferior safety profile with placebo.

Zhang and the team concluded that "This study confirmed that topical JAK and PDE4 inhibitors had promising treatment efficacy and safety for AD patients. Tofacitinib 2% b.i.d., ruxolitinib 1.5% b.i.d. and delgocitinib 3% b.i.d. showed superior efficacy over other JAK and PDE4 inhibitors."

Reference:

The study titled, "Efficacy and safety of topical Janus kinase and phosphodiesterase inhibitor-4 inhibitors for the treatment of atopic dermatitis: A network meta-analysis," is published in the Journal of Dermatology.

DOI: https://onlinelibrary.wiley.com/doi/abs/10.1111/1346-8138.16126