PracticeUpdate Conference Series World Congress of Dermatology 2019

Treatment History May Affect Effectiveness of Some Systemic Therapies for Psoriasis Findings could help clinicians choose optimal therapies for patients.

U sers of ciclosporin and acitretin who had used another systemic therapy for psoriasis in the past may be less likely to experience a reduction in psoriasis disease than those treated with these options as a first-line approach, accord- ing to results of a real-world, register-based study. “Patients with moderate-to-severe psoriasis are commonly prescribed non-biologic systemic therapies, including methotrexate, ciclosporin, acitretin, and fumaric acid esters,” study investi- gator Kayleigh J. Mason, PhD, of the University of Manchester in the United Kingdom, told Elsevier’s PracticeUpdate . “However, the effectiveness of these therapies in clinical practice is poorly under- stood, despite their widespread use.” For this real-world effectiveness study, investiga- tors used the British Association of Dermatologists Biologic and Immunomodulators Register (BADBIR),

a pharmacovigilance register investigating the long- term safety of systemic therapies in patients with psoriasis. The investigators identified 4113 patients with mod- erate-to-severe psoriasis in the register between 2007 and 2017 who received methotrexate, ciclo- sporin, acitretin, or fumaric acid esters with at least 6 months of follow-up. Among these patients, 1991 (48%) had been prescribed methotrexate, 1022 (25%) had been prescribed ciclosporin, 767 (19%)

Dr. Kayleigh J. Mason

Topical Ruxolitinib Shows Promise inRelieving Vitiligo Lesions A treatment for vitiligo approved by the United States Food and Drug Administration (FDA) remains an unmet clinical need. T opical ruxolitinib, a selective JAK1/ JAK2 inhibitor, significantly improved re-pigmentation of facial vitiligo active in vitiligo. The study was sponsored by Incyte, manufacturers of a proprietary topical formulation of ruxolitinib.

lesions in adult patients at 24 weeks com- pared with vehicle alone, according to the results of a dose-ranging phase II study. “There are about 3 million people who suf- fer with vitiligo in the United States, and yet [there is] no FDA-approved treatment for re-pigmentation,” David Rosmarin, MD, of the Tufts Medical Center in Boston, told Elsevier’s PracticeUpdate . “Patients with vitiligo often are stigmatized and have a compromised quality of life. … We are in need of new therapies for vitiligo.” Ruxolitinib is a nonsteroidal anti-inflam- matory therapy that functions by inhibiting the JAK pathway, which appears to be

The investigators found that significantly more patients achieved at least a 50% improvement from baseline in the Facial Vitiligo Area Severity Index (F-VASI50) at 24 weeks under all ruxolitinib-containing treatment regimens tested, relative to the vehicle control, meeting the study’s primary endpoint. “A treatment response was seen as early as week 8 in most treatment groups,” said Dr. Rosmarin. For the study, the investigators enrolled 157 adults aged 18 to 75 years with vitiligo who had depigmented areas of at least

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