Despite strong efficacy, dermatologist survey indicates Incyte's Opzelura uptake may face uphill climb: report

Atopic Dermatitis
SVB Leerink says a recent survey of dermatologists shows there is "an unmet need for novel topicals or other treatment options" in approximately two-thirds of patients with atopic dermatitis and psoriasis. (Shutterstock)

A survey of 50 United States-based dermatologists shows that they believe Incyte’s recently approved topical atopic dermatitis treatment, Opzelura, is effective but that safety concerns—as a JAK inhibitor—will hinder its uptake.

The study, which was commissioned by SVB Leerink and conducted by MEDACorp, shows that physicians believe Opzelura, also know as ruxolitinib, will be overtaken by other promising treatments which are in development, specifically Dermavant Sciences’ tapinarof and Arcutis Biotherapeutics’ roflumilast.

In August, the FDA accepted Dermavant’s approval application for tapinarof, a therapeutic aryl hydrocarbon receptor modulating agent. Arcutis is conducting phase 3 trials for roflumilast, which has the same active ingredient as AstraZeneca’s oral lung drug Daliresp, which was approved a decade ago for chronic obstructive pulmonary disease.

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In the survey, physicians rated Opzelura as good (36%), very good (50%) or excellent (14%) for atopic dermatitis and registered their concerns as neutral (20%), slightly concerning (44%) or very concerning (10%).

The results also indicate that more than three-quarters of dermatologists would reserve combination use of Opzelura for only some patients. Additionally, most would use Opzelura only after first trying corticosteroids or other topicals, regardless of the severity of the disease. The FDA approved Opzelura cream for mild-to-moderate patients who do not respond sufficiently to other topical prescription meds or when those treatments are not appropriate for the patient.

The survey also found that roughly two-thirds of patients under care for mild to severe forms of psoriasis and atopic dermatitis are on topical treatments (mostly corticosteroids) but that only one-third  maintain remission with topicals alone. This implies that there is “an unmet need for novel topicals or other treatment options in approximately two-thirds” of patients with these two conditions.

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The survey suggests that Dermavant’s tapinarof has a potentially best-in-class profile among topicals for both atopic dermatitis and psoriasis.

Earlier this year, the FDA made it a requirement for companies selling JAK inhibitors that treat certain chronic inflammatory conditions to warn about the increased risk of serious heart-related events, cancer, blood clots and death.