CHMP Recommends Approval of Opzelura Cream for Adults with Moderate Atopic Dermatitis – Incyte

 Incyte announced that the Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) has issued a positive opinion recommending the approval of Opzelura (ruxolitinib) cream for the treatment of moderate atopic dermatitis (AD) in adult patients for whom topical corticosteroids (TCSs) and topical calcineurin inhibitors (TCIs) are inadequate or inappropriate.

“AD is a chronic skin condition that can have a significant impact on daily life. The positive CHMP opinion for Opzelura marks meaningful progress toward bringing the first non-steroidal topical JAK treatment option to adults in Europe with moderate AD for whom standard topical therapies have failed. If approved by the European Commission, Opzelura could help address an important gap for patients who have limited treatment options when TCSs and TCIs are inadequate or inappropriate.” – Lee Heeson, Executive Vice President and Head of Incyte International.

The positive CHMP opinion is based on results from the pivotal Phase 3 TRuE-AD4 study (NCT06238817), supported by the Phase 3 TRuE-AD1 (NCT03745638) and TRuE-AD2 (NCT03745651) studies, evaluating the safety and efficacy of ruxolitinib cream in adults with AD.

In TRuE-AD4, ruxolitinib cream significantly improved the clinical signs and symptoms of moderate AD, including itch, as early as Day 2 and was well tolerated in adults who had an inadequate response, intolerance or contraindication to both TCSs and TCIs.3 The TRuE-AD4 study met its co-primary endpoints at Week 8, with a statistically significantly higher proportion of patients on ruxolitinib cream versus vehicle cream achieving a ≥75% improvement from baseline in the Eczema Area and Severity Index (EASI75), and, separately, Investigator’s Global Assessment Treatment Success (IGA-TS, defined as an IGA score of 0 [clear] or 1 [almost clear] with at least a two-point improvement from baseline).

Efficacy was maintained following the initial treatment period with 84.3% of patients achieving EASI75 and 70.6% achieving IGA-TS with as needed therapy at Week 24.5 Mean affected body surface area (BSA) decreased markedly from 15.1% at baseline to 2.5% at Week 8 and remained low at Week 24 (2.5%), while itch relief (NRS4; ≥4-point improvement in Itch Numeric Rating Scale) remained high (74.3% at Week 8 and 64.7% at Week 24) with ruxolitinib cream treatment.

Additionally, patients treated with ruxolitinib cream also showed improvements in quality of life, with mean Dermatology Life Quality Index (DLQI) scores improving from 19.3 at baseline to 4.3 at Week 8, compared with 19.1 to 10.7 with vehicle cream (control).

Ruxolitinib cream was well tolerated, with no serious infections, major adverse cardiovascular events, malignancies or thromboses reported during the 24-week treatment period. The most common treatment-emergent adverse events were upper respiratory tract infection (10.6%) and nasopharyngitis (6.3%).

“In clinical practice, many adults with moderate AD do not achieve the level of disease control they need, despite available topical therapies, and the impact on quality of life can be considerable. The data supporting this positive CHMP opinion suggest that ruxolitinib cream may offer an effective new topical treatment option for appropriate adult patients in Europe and may help delay or prevent progression to systemic therapy, potentially helping to address an important gap for those who have struggled to achieve lasting relief.” – Dr. Andreas Wollenberg, Professor of Dermatology and Allergy, University Hospital Augsburg, Germany.

AD, the most common type of eczema, is a chronic, recurring, inflammatory and highly pruritic skin condition that affects up to 4% of adults worldwide, with an estimated prevalence of 4.4-7.1% of adults in Europe. Signs and symptoms include irritated and itchy skin that can cause red lesions that may ooze and crust.

The CHMP opinion is now being reviewed by the European Commission (EC), which has the authority to grant approval for all centrally authorized products in the European Union (EU). If approved, this would be the second indication for Opzelura in the EU, which was previously approved by the EC for the treatment of non-segmental vitiligo with facial involvement in adults and adolescents from 12 years of age.

About TRuE-AD4

TRuE-AD4 (NCT06238817) is a randomized, double-blind, vehicle-controlled Phase 3b study designed to evaluate the efficacy and safety of Opzelura (ruxolitinib) cream in adults with moderate atopic dermatitis (AD). The study enrolled 241 patients (≥18 years old) who met the specific inclusion criteria, including an IGA (Investigator’s Global Assessment) score of 3 and an EASI (Eczema Area and Severity Index) score greater than 7 at both screening and Day 1, and who have AD on 10% to 20% of their Body Surface Area (BSA; excluding scalp). Patients also had to have a documented history of inadequate response, intolerance, or contraindication to topical corticosteroids (TCSs) and topical calcineurin inhibitors (TCIs) within the 12 months prior to the screening visit.

Patients were randomized 2:1 to receive Opzelura applied twice daily (BID) or vehicle (non-medicated cream) BID. At Week 8, patients who achieved EASI50 continued double-blind, BID treatment, applied as needed for an additional 16 weeks. Patients for whom EASI50 was not achieved at two consecutive visits ≥1 week apart were eligible to enter the escape arm at Week 8 or later, in which open-label Opzelura cream was applied as needed.

The co-primary endpoints of TRuE-AD4 were the proportion of patients achieving IGA Treatment Success (IGA-TS), defined as an IGA score of 0 (clear) or 1 (almost clear) with at least a two-point improvement from baseline, and EASI75, defined as ≥75% improvement in EASI score, at Week 8. Secondary endpoints included the proportion of patients with a ≥4-point improvement in NRS4 (≥4-point improvement in Itch Numeric Rating Scale) score at various time points. Other efficacy measures included the proportion of patients who achieved IGA-TS, NRS4, EASI75, a reduction from baseline in the affected body surface area (%BSA), change from baseline in the skin pain NRS score, EASI50 and more, measured at various time points. The study also tracked the frequency, duration and severity of adverse events associated with the use of Opzelura.

For more information on the study, visit https://www.clinicaltrials.gov/study/NCT06238817