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As a dermatologist, Dr. Amy Spizuoco has a front-row seat to the experience of patients with atopic dermatitis (AD). For many of her patients, controlling AD can be challenging despite having tried at-home remedies, over-the-counter treatments, and prescription medications.
Life with AD
AD is a chronic skin condition characterized by inflammation and constant itch impacting more than 21 million people ages 12 years and older in the U.S. Other symptoms include irritated skin, red lesions that may ooze and crust, and dry scaly patches. AD most commonly occurs on the face, inside the elbows, or behind the knees, and is triggered by a dysregulation of the immune system.
The persistent itch and discomfort of AD can significantly impact people’s lives, interfering with everyday activities and even disrupting sleep. Nearly two out of three people report experiencing itch most days of the week. AD can also come and go, making the condition more frustrating to manage for some.
Dr. Spizuoco, associate clinical instructor in the department of dermatology at The Icahn School of Medicine at Mount Sinai, and president-elect of the American Osteopathic College of Dermatology, empathizes with her patients’ frustrations:
“People with AD often come to me exhausted because they can’t get their condition under control. The discomfort from symptoms, including persistent itch, often prevents them from enjoying daily activities. One of my top priorities is to create a simple treatment plan that meets their individual needs. AD can be difficult to manage for some, and there are treatment options available that can help.”
People may try different approaches to manage their AD, such as using lotion to keep skin moisturized or medications like topical corticosteroids, either over-the-counter or prescribed by a doctor. Some may find success with one of these approaches while others may not find relief or may lose the response to treatment over time, depending on how their body responds.
“AD manifests differently depending on the patient, which often results in patients cycling through different therapies trying to find solutions that address their particular experience,” says Dr. Spizuoco. “Many people end up using a complicated mix of products, which can feel overwhelming. It’s important that people with AD partner with a dermatologist early on to determine the best and most direct approach to get their condition under control. While treatment options for AD have been limited to date, there have been recent advances and we now have new treatment options to consider for some patients. For people living with AD who haven’t found relief, I recommend reaching out to a dermatologist to revisit the conversation and discuss a new approach.”
Determining if it’s Time for a New Treatment Approach
Novel therapies for the treatment of AD have recently become available. Opzelura™ (ruxolitinib) cream 1.5% is one of the newest treatments for mild to moderate AD, recently approved by the FDA for the short-term and non-continuous treatment of mild to moderate AD in patients 12 years and older without weakened immune systems whose disease is uncontrolled with topical prescription therapies, or when those therapies are not recommended. It is a non-steroidal topical cream that targets a pathway believed to be a source of the itch and inflammation behind AD.
“Opzelura meets an important need in the treatment of AD, as a non-steroidal topical therapy,” Dr. Spizuoco said. “The way it works may make an impact on itch. In clinical trials, we saw that patients treated with Opzelura experienced significantly clearer skin and itch reduction, compared to those treated with non-medicated cream. As a clinician, I’m encouraged by these results, and welcome a new treatment option for certain patients with mild to moderate AD.”
The most common (≥1%) adverse reactions associated with Opzelura are nasopharyngitis, diarrhea, bronchitis, ear infection, eosinophil count increased, urticaria, folliculitis, tonsillitis and rhinorrhea. Please see below for Important Safety Information, including Boxed Warnings for serious infections, mortality, malignancy, major adverse cardiovascular events and thrombosis.
“It is important to note that the FDA has required that certain warnings and precautions be included for JAK inhibitors, including Opzelura,” says Dr. Spizuoco. “I will carefully review risk factors with my patients to evaluate if this is an appropriate treatment for them, and I encourage people to work with their healthcare providers to discuss the appropriate use of Opzelura – and any therapy – as part of their individualized treatment plan.”
Opzelura may work for some but not all patients. To learn more, visit www.Opzelura.com.
Tips for Managing AD
Dr. Spizuoco shares the following tips to encourage people with AD to take an active role in managing their condition:
- Learn as much as possible about AD – knowledge is power!
- Identify individual triggers to understand what may be driving flares
- Build a strong relationship with a trusted dermatologist and work together on a personalized treatment approach
- Come to appointments prepared with questions and openly express any concerns – big or small
- Do research and work with healthcare providers to make informed decisions about potential treatment options
- Connect with other people with similar experiences, and consider joining a local support group or advocacy group
- Lean on family and friends – don’t be afraid to ask for help when needed
“While difficult, AD can be successfully managed,” said Dr. Spizuoco. “There are therapies that can help. Stay positive! Most importantly, work closely with a dermatologist who can be a strong advocate and help navigate any challenges that may arise along the way.”
IMPORTANT SAFETY INFORMATION
OPZELURA cream is for use on the skin only. Do not use OPZELURA cream, in your eyes, mouth or vagina.
OPZELURA may cause serious side effects, including:
Serious Infections: OPZELURA cream contains ruxolitinib. Ruxolitinib belongs to a class of medicines called Janus kinase (JAK) inhibitors. JAK inhibitors are medicines that affect your immune system. JAK inhibitors can lower the ability of your immune system to fight infections. Some people have had serious infections while taking JAK inhibitors by mouth, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have been hospitalized or died from these infections. Some people have had serious infections of their lungs while taking OPZELURA. Your healthcare provider should watch you closely for signs and symptoms of TB during treatment with OPZELURA.
OPZELURA should not be used in people with an active, serious infection, including localized infections. You should not start using OPZELURA if you have any kind of infection unless your healthcare provider tells you it is okay. You may be at a higher risk of developing shingles (herpes zoster) while using OPZELURA.
Increased risk of death from all causes, including sudden cardiac death, has happened in people taking JAK inhibitors by mouth.
Cancer and immune system problems: OPZELURA may increase your risk of certain cancers by changing the way your immune system works. Some people have had lymphoma and other cancers while taking JAK inhibitors by mouth, especially if they are a current or past smoker. Some people have had skin cancers while taking OPZELURA. Your healthcare provider will regularly check your skin during your treatment with OPZELURA.
There is an increased risk of major cardiovascular events such as heart attack, stroke or cardiac death in people with cardiovascular risk factors and who are current or past smokers while using JAK inhibitors to treat inflammatory conditions.
Blood clots: Blood clots in the veins of your legs (deep vein thrombosis, DVT) or lungs (pulmonary embolism, PE) can happen in some people taking OPZELURA. This may be life-threatening.
Low blood cell counts: OPZELURA may cause low platelet counts (thrombocytopenia), low red blood cell counts (anemia), and low white blood cell counts (neutropenia). If needed, your healthcare provider will do a blood test to check your blood cell counts during your treatment with OPZELURA and may stop your treatment if signs or symptoms of low blood cell counts happen.
Cholesterol increases: Cholesterol increase has happened in people when ruxolitinib is taken by mouth. Tell your healthcare provider if you have high cholesterol or triglycerides.
Before starting OPZELURA, tell your healthcare provider if you:
- have an infection, are being treated for one, or have an infection that keeps coming back
- have diabetes, chronic lung disease, HIV, or a weak immune system
- have or had TB, or have been in close contact with someone with TB
- have had shingles (herpes zoster) or hepatitis B or C
- live, have lived in, or have traveled to certain parts of the country (such as the Ohio and Mississippi River valleys and the Southwest) where there is an increased chance for getting certain kinds of fungal infections. These infections may happen or become more severe if you use OPZELURA. Ask your healthcare provider if you do not know if you have lived in an area where these infections are common.
- think you have an infection or have symptoms of an infection such as:
- have ever had any type of cancer, or are a current or past smoker
- have had blood clots in the veins of your legs or lungs in the past
- have high cholesterol or triglycerides
- have or have had low white or red blood cell counts
- are pregnant or plan to become pregnant. It is not known if OPZELURA will harm your unborn baby. There is a pregnancy exposure registry for individuals who use OPZELURA during pregnancy. The purpose of this registry is to collect information about the health of you and your baby. If you become exposed to OPZELURA during pregnancy, you and your healthcare provider should report exposure to Incyte Corporation at 1-855-463-3463.
- are breastfeeding or plan to breastfeed. It is not known if OPZELURA passes into your breast milk. Do not breastfeed during treatment with OPZELURA and for about 4 weeks after the last dose.
After starting OPZELURA:
- Call your healthcare provider right away if you have any symptoms of an infection. OPZELURA can make you more likely to get infections or make worse any infections that you have.
- Get emergency help right away if you have any symptoms of a heart attack or stroke while using OPZELURA, including:
- discomfort in the center of your chest that lasts for more than a few minutes, or that goes away and comes back
- severe tightness, pain, pressure, or heaviness in your chest, throat, neck, or jaw
- pain or discomfort in your arms, back, neck, jaw, or stomach
- shortness of breath with or without chest discomfort
- breaking out in a cold sweat
- nausea or vomiting
- feeling lightheaded
- weakness in one part or on one side of your body
- slurred speech
- Tell your healthcare provider right away if you have any signs and symptoms of blood clots during treatment with OPZELURA, including: swelling, pain or tenderness in one or both legs, sudden, unexplained chest or upper back pain, or shortness of breath or difficulty breathing.
- Tell your healthcare provider right away if you develop or have worsening of any symptoms of low blood cell counts, such as: unusual bleeding, bruising, tiredness, shortness of breath or fever.
Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements.
The most common side effects of OPZELURA include: pain or swelling in your nose or throat (nasopharyngitis), diarrhea, bronchitis, ear infection, increase in a type of white blood cell (eosinophil) count, hives, inflamed hair pores (folliculitis), swelling of the tonsils (tonsillitis), and runny nose (rhinorrhea).
These are not all of the possible side effects of OPZELURA. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088. You may also report side effects to Incyte Corporation at 1-855-463-3463.
INDICATION AND USAGE
OPZELURA is a prescription medicine used on the skin (topical) for short-term and non-continuous treatment of mild to moderate eczema (atopic dermatitis) in non-immunocompromised people 12 and older whose disease is not well controlled with topical prescription therapies or when those therapies are not recommended.
The use of OPZELURA along with therapeutic biologics for atopic dermatitis, other JAK inhibitors, or strong immunosuppressants such as azathioprine or cyclosporine is not recommended.
 Silverberg JI, Gelfand JM, Margolis DJ, et al. Atopic dermatitis in US adults: from population to health care utilization. J Allergy Clin Immunol Pract. 2019;7(5):1524-1532.
 Boguniewicz M, Fonacier L, Guttman-Yassky E, et al. Atopic dermatitis yardstick: practical recommendations for an evolving therapeutic landscape. J. Ann Allergy Asthma Immunol. 2018;120(1):10-22.
 Opzelura™ (ruxolitinib) cream Prescribing Information. 2021.
OPZELURA is a trademark of Incyte.
© 2021, Incyte Corporation. MAT-OPZ-00269 12/21