Labib Angelina, Yosipovitch Gil
Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery and Miami Itch Center, University of Miami Miller School of Medicine, Miami, FL, USA.
Expert Rev Clin Immunol. 2022 Nov;18(11):1107-1118. doi: 10.1080/1744666X.2022.2126353. Epub 2022 Sep 29.
Atopic dermatitis (AD) is a common itchy inflammatory skin condition that affects many individuals. For many years, the landscape of AD treatment remained unchanged; however, there has been developing therapies that directly target the underlying immunological mechanism of AD. Janus kinase (JAK) inhibitors are small molecules that have shown anti-inflammatory and anti-itch effects in AD. Recently, abrocitinib, an oral JAK 1 inhibitor, was approved by the Food and Drug Administration for atopic dermatitis.
By downregulating the immune cascade, abrocitinib has demonstrated the ability to curb symptoms of AD, including rapidly reducing pruritus in 2-3 days, and is safe and well-tolerated overall despite a low increased risk in infection. The data discussed was obtained from a comprehensive literature review utilizing PubMed.
Abrocitinib has strong efficacy, likely due to its broader mechanism of action provided by the inhibition of key regulatory molecule, JAK. Results have demonstrated that it is more efficacious at curbing symptoms of AD than dupilumab, the current treatment of choice for refractory, moderate-to-severe AD. While abrocitinib provides a great alternative treatment, particularly for non-responders and AD subtypes, it also demonstrates a stronger side effect profile that must be considered.
特应性皮炎(AD)是一种常见的瘙痒性炎症性皮肤病,影响着许多人。多年来,AD的治疗格局一直未变;然而,目前已经出现了直接针对AD潜在免疫机制的治疗方法。Janus激酶(JAK)抑制剂是一类小分子药物,已在AD中显示出抗炎和止痒作用。最近,口服JAK 1抑制剂阿布昔替尼已获美国食品药品监督管理局批准用于治疗特应性皮炎。
通过下调免疫级联反应,阿布昔替尼已证明有能力控制AD症状,包括在2 - 3天内迅速减轻瘙痒,并且总体上安全且耐受性良好,尽管感染风险略有增加。所讨论的数据来自利用PubMed进行的全面文献综述。
阿布昔替尼具有强大的疗效,可能是由于其通过抑制关键调节分子JAK提供了更广泛的作用机制。结果表明,在控制AD症状方面,它比度普利尤单抗(目前难治性中重度AD的首选治疗药物)更有效。虽然阿布昔替尼提供了一种很好的替代治疗方法,特别是对于无反应者和AD亚型,但它也显示出更强的副作用,必须予以考虑。