Therapeutic outcomes across Janus kinase inhibitors in prurigo nodularis.
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Avallone Gianluca, Bombelli Andrea, Valtellini Luca, Tavoletti Gianluca, Galli Benedetta, Rossi Mariateresa, Maurelli Martina, Girolomoni Giampiero, Gargiulo Luigi, Narcisi Alessandra, di Vico Francesca, Napolitano Maddalena, Lazzeri Laura, Calabrese Laura, Caccavale Stefano, Balato Anna, Barei Francesca, Calzari Paolo, Foti Caterina, Trave Ilaria, Cozzani Emanuele, Rongioletti Franco, Lenti Sveva, Gurioli Carlotta, Nettis Eustachio, Caroppo Francesca, Errichetti Enzo, Bonzano Laura, Gori Niccolò, Peris Ketty, Lembo Serena, Del Regno Laura, Esposito Maria, Fargnoli Maria C, Savoia Paola, Esposto Elia, Giuffrida Roberta, Guarneri Fabrizio, Patruno Cataldo, Pezzolo Elena, Stingeni Luca, Hansel Katharina, Mastorino Luca, Ortoncelli Michela, Ribero Simone, Marzano Angelo V, Ferrucci Silvia M
Аннотация
OBJECTIVES: To investigate clinical findings and treatment outcomes among patients diagnosed with PN and treated with JAKis in a real-world setting.
METHODS: Retrospective cohort study across 23 Italian tertiary referral hospitals. Patients with PN were eligible if aged ≥ 18 years and had received a JAKi with a minimum follow-up of 12 weeks. The primary outcome was defined as the proportion of patients achieving a reduction of ≥ 4 points from baseline in the Peak Pruritus Numerical Rating Scale score. Key secondary outcomes included the rates of patients reaching a significant reduction in Investigator Global Assessment of Prurigo Nodularis Stage (IGA PN-S) and Investigator Global Assessment of Prurigo Nodularis Activity (IGA PN-A) scores.
RESULTS: Of the total, 71 patients met the inclusion criteria. At week 16, the proportion of patients achieving the primary outcome was 94% for upadacitinib [n = 52/55; 95% confidence interval (CI) 87-100%], 83% for abrocitinib (n = 10/12; 95% CI 52-98%) and 100% for baricitinib (n = 4/4; 95% CI 40-100%), with results sustained at week 24. An IGA PN-A score of 0/1 was achieved in 90% of patients treated with upadacitinib and abrocitinib and in 50% of those on baricitinib by week 24. Improvements were observed across all other secondary outcomes assessed, with no safety concerns reported.
CONCLUSIONS: This study suggests that JAKis can achieve clinically meaningful outcomes in PN irrespective of atopic background, supporting their use across diverse patient profiles. Further research is warranted to validate these observations and explore their long-term effects.