(107) Real-world effect of ruxolitinib cream: decreased use of additional topical therapies and limited escalation to systemic treatments

Background: : Ruxolitinib cream has shown efficacy with a well-tolerated safety profile in patients aged ≥2 years with mild to moderate atopic dermatitis (AD) in clinical trials. Early real-world data in adolescents and adults have shown efficacy and safety results consistent with clinical trial observations.

Objective: : This study examined the long-term effect of ruxolitinib cream on real-world treatment patterns in AD, including among patients previously treated with topical (corticosteroids [TCS], calcineurin inhibitors [TCI], phosphodiesterase-4 [PDE-4] inhibitors) or systemic (corticosteroids, biologics) therapy.

Methods: : A retrospective cohort analysis was conducted using claims data from the Healthcare Integrated Research Database (HIRD®) to identify ruxolitinib cream users aged ≥12 years from October 1, 2021, to July 31, 2022. The index date was the first ruxolitinib cream claim. The study included a 6-month baseline period and an 18-month follow-up, divided into 3 intervals: months 1–6, 7–12, and 13–18. Biologic therapy experience was determined based on baseline treatment history.

Results: : Ruxolitinib cream users (N=1269) with a mean (SD; range) of 2.4 (2.3; 1–19) ruxolitinib cream fills over 18 months were included. Of biologic-naive patients (n=1038), 92.7%, 91.8%, and 91.0% did not receive biologic therapy during months 1–6, 7–12, and 13–18, respectively. Of biologic-experienced patients (n=231), 17.3%, 28.6%, and 35.5% did not receive biologic therapy during months 1–6, 7–12, and 13–18, respectively. TCS use declined from 53.0% at baseline to 29.8% in months 1–6, 26.3% in months 7–12, and 25.5% in months 13–18. TCI use decreased from 14.2% at baseline to 5.9% in months 1–6, 4.3% in months 7–12, and 5.3% in months 13–18. Topical PDE-4 inhibitor use was reduced from 4.3% at baseline to 2.2% in months 1–6, 1.4% in months 7–12, and 1.3% in months 13–18. Systemic corticosteroid use declined steadily, with cumulative prednisone-equivalent dose reduced from 78.4 mg at baseline to 67.5 mg in months 1–6, 56.0 mg in months 7–12, and 53.7 mg in months 13–18.

Conclusions: : At 18 months after initiation of ruxolitinib cream, biologic-experienced patients continued to show reduced biologic treatment fills. Among biologic-naive patients, the majority (>90%) did not escalate to biologic therapy. Additionally, use of both topical and systemic corticosteroids decreased over time. These trends suggest that ruxolitinib cream remains an effective treatment option for adolescents and adults with AD, reducing the need for additional topical therapies and limiting escalation to systemic treatments.

Sponsorship:: Incyte Corporation