Raj Chovatiya, MD, PhD, and Lisa Swanson, MD, FAAD, examine the clinical context for the approval of topical ruxolitinib and its role in the treatment armamentarium.
Raj Chovatiya, MD, PhD: Before we jump into some of the more clinical data, Lisa, what’s your experience been like with JAK inhibitors in the real world when it comes to treatment? Remember, we have 3 really good options: a topical ruxolitinib cream, a JAK1/2 selective inhibitor for mild to moderate atopic dermatitis, and 2 oral agents that are systemic therapy for moderate to severe atopic dermatitis. Abrocitinib and upadacitinib are a bit more JAK1 selective.
Lisa Swanson, MD, FAAD: Definitely, yes. Let’s start with topical ruxolitinib. It was the first 1 that came to market, so we’ll start there. Topical ruxolitinib is approved for mild to moderate atopic dermatitis in patients ages 12 and up. My experience has been fantastic. It’s the first topical nonsteroid that can have the same or similar efficacy of a topical steroid in terms of the speed of onset and overall effectiveness. Patients like it. It has a nice feel to it. Stinging and burning are uncommon. I love it for my patients who might be on the autism spectrum or have some tactile sensitivity because they like the way it feels. They’re OK with that. I’ve seen fantastic efficacy and speed to improvement and general patient satisfaction with topical ruxolitinib.
Raj Chovatiya, MD, PhD: You mentioned 1 important pro there: it’s a cream. It’s not an ointment, and that’s exciting because we always get caught up in this idea that you’ve got to use ointments and not creams because they work better. But in a lot of my real-world experience, I’ve seen topical ruxolitinib perform much like your moderate- to higher-potency steroidal agents in terms of speed of onset and ability to clear things up. It’s been a welcome armamentarium, particularly for people who might have more limited disease. Topicals don’t work for everybody. On label, 3% to 20% is the way topical ruxolitinib was studied. That’s a pretty good reflection of how my patients are using it in the real world.
Transcript edited for clarity