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Introduction <p>Atopic dermatitis (AD) is a chronic, highly pruritic, relapsing inflammatory disease associated with high quality-of-life burden. Topical 1.5% ruxolitinib cream is a selective Janus kinase (JAK)1/JAK2 inhibitor that is well tolerated and effective in improving itch and lesion clearance in patients ≥ 12&#xa0;years old. This analysis estimates comparative efficacy for 1.5% ruxolitinib cream relative to systemic therapies for treatment of patients ≥ 12&#xa0;years with AD.</p> Methods <p>A systematic literature review (SLR) identified randomized controlled trials evaluating 1.5% ruxolitinib cream, oral JAK inhibitors, monoclonal antibodies, phosphodiesterase&#xa0;4 inhibitors, and systemic immunosuppressants. A feasibility assessment evaluated whether indirect treatment comparison (ITC) was appropriate and determined appropriate ITC methods. This network meta-analysis (NMA) assessed the comparative efficacy of 1.5% ruxolitinib cream against systemic therapies in a “systemic-eligible moderate AD” subgroup defined as ≥ 12&#xa0;years old and eligible for topical and systemic therapies (Investigator’s Global Assessment [IGA] = 3, Eczema Area and Severity Index [EASI] ≥ 16, and body surface area ≥ 10%); an ITC with the full study populations was not feasible. A frequentist framework using a penalized likelihood NMA included outcomes of IGA&#xa0;0/1 with at least a 2-point improvement from baseline, EASI-75, and Itch Numerical Rating Scale&#xa0;4 (NRS4).</p> Results <p>The SLR identified 25 studies, of which 12 reported outcomes for the relevant subgroup for four interventions: 1.5% ruxolitinib cream, dupilumab 300&#xa0;mg, upadacitinib (15&#xa0;mg, 30&#xa0;mg), and abrocitinib (100&#xa0;mg, 200&#xa0;mg), which were compared against placebo or placebo + topical corticosteroids. There were no statistically significant differences between active comparators for IGA&#xa0;0/1, EASI-75, and Itch NRS4, although point estimates numerically favored 1.5% ruxolitinib cream for IGA&#xa0;0/1 and EASI‑75.</p> Conclusion <p>For patients with moderate AD who are eligible for systemic therapies, 1.5% ruxolitinib cream might provide disease control comparable to systemic treatments, such as dupilumab, regarding IGA&#xa0;0/1, EASI-75, and Itch NRS4.</p>

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Network Meta-analysis of 1.5% Ruxolitinib Cream Versus Systemic Agents in the Treatment of Moderate Atopic Dermatitis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年9月4日

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  • Melinda J. Gooderham,
  • H. Chih-ho Hong,
  • Di Wang,
  • Becky Hooper,
  • Avery Hughes-Martin,
  • Heather Cameron,
  • Laura Pastor,
  • Alicia Pepper,
  • Ping Wu,
  • Ali Mojebi,
  • Grace Wong,
  • Rafael Marino,
  • Marie-Lise Dion,
  • Mehdi Larbi

摘要

Introduction

Atopic dermatitis (AD) is a chronic, highly pruritic, relapsing inflammatory disease associated with high quality-of-life burden. Topical 1.5% ruxolitinib cream is a selective Janus kinase (JAK)1/JAK2 inhibitor that is well tolerated and effective in improving itch and lesion clearance in patients ≥ 12 years old. This analysis estimates comparative efficacy for 1.5% ruxolitinib cream relative to systemic therapies for treatment of patients ≥ 12 years with AD.

Methods

A systematic literature review (SLR) identified randomized controlled trials evaluating 1.5% ruxolitinib cream, oral JAK inhibitors, monoclonal antibodies, phosphodiesterase 4 inhibitors, and systemic immunosuppressants. A feasibility assessment evaluated whether indirect treatment comparison (ITC) was appropriate and determined appropriate ITC methods. This network meta-analysis (NMA) assessed the comparative efficacy of 1.5% ruxolitinib cream against systemic therapies in a “systemic-eligible moderate AD” subgroup defined as ≥ 12 years old and eligible for topical and systemic therapies (Investigator’s Global Assessment [IGA] = 3, Eczema Area and Severity Index [EASI] ≥ 16, and body surface area ≥ 10%); an ITC with the full study populations was not feasible. A frequentist framework using a penalized likelihood NMA included outcomes of IGA 0/1 with at least a 2-point improvement from baseline, EASI-75, and Itch Numerical Rating Scale 4 (NRS4).

Results

The SLR identified 25 studies, of which 12 reported outcomes for the relevant subgroup for four interventions: 1.5% ruxolitinib cream, dupilumab 300 mg, upadacitinib (15 mg, 30 mg), and abrocitinib (100 mg, 200 mg), which were compared against placebo or placebo + topical corticosteroids. There were no statistically significant differences between active comparators for IGA 0/1, EASI-75, and Itch NRS4, although point estimates numerically favored 1.5% ruxolitinib cream for IGA 0/1 and EASI‑75.

Conclusion

For patients with moderate AD who are eligible for systemic therapies, 1.5% ruxolitinib cream might provide disease control comparable to systemic treatments, such as dupilumab, regarding IGA 0/1, EASI-75, and Itch NRS4.