Lecture Updates on Abrocitinib, Povorcitinib for PN

Dr. Shawn Kwatra gets goosebumps when he thinks about having two approved biologics for prurigo nodularis, (PN) he said during a session at the 44th Annual Fall Clinical Dermatology Conference.

“I have to pinch myself,” Dr. Kwatra said during “Making the Connection Between Prurigo Nodularis, Atopic Dermatitis, and Itch,” which he presented alongside Dr. Tejesh Patel and Dr. Mona Shahriari.

In addition to overviews of itch and systemic therapies for atopic dermatitis (AD), the trio presented data on from the recent EADV Congress on abrocitinib and povorcitinib for PN. With abrocitinib treatment, 30% of patients in a study experienced a ≥2-point decrease in investigator global assessment (IGA) after 12 weeks; no serious adverse events were observed. Meanwhile, in a 40-week, Phase 2 clinical trial of oral povorcitinib in patients with PN, 35.1% of patients receiving 75-mg doses reached both primary endpoints of ≥4-point improvement from baseline in Itch NRS (NRS4) and IGA treatment success (IGA-TS), compared with 2.7% of placebo patients; only 6.3% of those experience serious adverse events.

“This is the most exciting time in the history of itch because there is a revolution of new therapies and new options for patients,” Dr. Kwatra told Practical Dermatology. “We want to increase awareness so that all dermatologists and all providers are asking about itch severity and we are able to initiate early treatment. It’s spanning across diseases, from atopic dermatitis to prurigo nodularis to other conditions. We are really discovering a lot of new biomarkers and therapeutic targets, and following through with highly effective, targeted small-molecule inhibitor therapy. There is an unprecedented pipeline of new therapeutics. … We just need to educate doctors and providers about all the advances because they are happening so fast.”

Dr. Kwatra noted the effectiveness of showing dramatic before-and-after photography in the presentation.

“Showing real-life cases with folks who have terribly disfiguring disease and uncontrollable itch that is wracking their quality of life, then got totally clear, is impactful,” he said. “Itch is actually one of the rings of hell in Dante’s Inferno. It’s right up there with feces raining down from the heaven and burning blood. People underestimate how severe itch is. This gives hope that we can now treat a lot of these patients.”