JAKi options added to Dupixent for atopic dermatitis

Reimbursement standards expanded for Olumiant·Rinvoq in AD from May

Expected to bring versatility in use due to their different MoAs… relatively cheaper price also a strength

Two new treatment options were added to the field of atopic dermatitis that had only Dupixent as an option.

 

The new options are both JAK inhibitors.

 

The Ministry of Health and Welfare had issued a pre-administrative notice on the ‘Details on the standard and methods for applying long-term care benefits (pharmaceuticals)’ and announced it will expand the scope of reimbursement for two types of JAK inhibitors – Lilly Korea’s ‘Olumiant (baricitinib),’ and Abbvie Korea’s ‘Rinvoq (upadacitinib)’ – in atopic dermatitis.

 

With the approval, JAK inhibitors have entered the field of atopic dermatitis in just one year since applying for reimbursement (for Olumiant).

 

By reimbursement standards, the drugs may be used for the treatment of patients with severe chronic atopic dermatitis whose condition has lasted for over 3 years and whose symptom is not adequately controlled despite the use of topical treatment (corticosteroids and/or calcineurin inhibitors) and does not respond to over 3 months of systemic immunosuppressants (cyclosporine or methotrexate) (which is measured by a 50% or more reduction of EASI) or is not eligible for their use due to side effects, and whose EASI score is 23 or higher before starting treatment.

 

As both drugs are relatively cheaper than Dupixent, the drugs are expected to become major options in the field of atopic dermatitis in the future.

 

Dupixent selectively inhibits IL-4, and IL-13, which are known as key cytokines that cause atopic dermatitis.

 

The drug is highly effective as it targets specific cytokines, but may not be as effective in some patients.

 

On the other hand, JAK inhibitors including Rinvoq are involved in a relatively broader set of cytokines.

 

The cytokines deliver signals through various pathways including the JAK-STAT pathway by binding to their receptors on the cell surface, and JAK inhibitors target the JAK enzyme that orders proteins that play a key role in Immune-inflammation regulation.

 

The differences in MOA also bring other differences.

 

The biologic agent Dupixent is an injection type of drug whereas JAK inhibitors are small-molecule drugs that can be taken orally.

 

Oral drugs like Rinvoq can be a good alternative that can increase convenience for patients who have trouble receiving regular injections in clinics.

 

Meanwhile, the insurance authorities are discussing extending reimbursement of Dupixent to pediatric and adolescent patients with atopic dermatitis.