Photo Credit: Md Saiful Islam Khan
More than half of the participants in a phase 2 trial reported improvements in itch on the highest study dose of povorcitinib.
Povorcitinib outperformed placebo in treating prurigo nodularis (PN). More than half of the participants in this phase 2 trial achieved at least a 4-point improvement in itch on the numeric rating scale (NRS4) on the highest study dose of povorcitinib.
A novel management option for PN was explored in a phase 2 trial (NCT05061693) comparing the JAK1 inhibitor povorcitinib with placebo. The study team randomized 146 participants to placebo or 1 of 3 povorcitinib regimens (ie, 15 mg, 45 mg, and 75 mg daily).
“We see a typical population with a lot of comorbidities,” Martin Metz, MD, commented on the baseline findings. He pointed to a mean body mass index of 31.5 kg/m2, a mean itch of NRS8, and a much-impaired quality of life.
The primary endpoint was the rate of participants with NRS4 at week 16, which showed significant and dose-dependent superiority in the 15 mg, 45 mg, and 75 mg arms of povorcitinib compared with placebo: 36.1% (P<0.01), 44.4% (P<0.001), 54.1% (P<0.001) versus 8.1%. The highest dose demonstrated the fastest efficacy with a median time of 17 days to itch NRS4. Treatment success in the Investigator’s Global Assessment (IGA-TS) in terms of an IGA 0/1 with greater than or equal to 2-grade improvement from baseline was achieved by 13.9%, 30.6%, and 48.6% on the study drug compared with 5.4% on placebo. Proportions of participants reaching the combination of NRS4 and IGA-TS were also higher in the povorcitinib with 8.3% (15 mg), 22.2% (45 mg), and 35.1% (75 mg) versus placebo 2.7%.
Overall, the JAK inhibitor was well-tolerated. Headache was the most common treatment-emergent adverse event in 11.1% of those treated with povorcitinib. One death occurred that was deemed not related to treatment.
In his conclusion, Dr. Metz pointed to the early and meaningful impact of povorcitinib on itch. Thus, the agent might be a promising potential treatment for PN.
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