MECHANISM OF ACTION
TARGET A SOURCE OF ITCH AND INFLAMMATION1-3
OPZELURA TARGETS THE SIGNALING OF KEY CYTOKINES (IL-4, IL-13, IL-31, and TSLP) BELIEVED TO CONTRIBUTE TO INFLAMMATION AND ITCH IN AD1-3,5
OPZELURA is a topical JAK inhibitor designed to target the signaling of key cytokines believed to be critical to the Th2 response in AD, which contribute to1-5:
Itch and inflammation: IL-4, IL-13, IL-31, and TSLP
JAKs are intracellular signaling enzymes that act downstream of many inflammatory cytokines involved in AD pathogenesis.2
Ruxolitinib, the active ingredient in OPZELURA, binds to the JAK enzyme, inhibiting both JAK and STAT activation. As a result, inflammatory mediators are interrupted.1,3
The relevance of specific JAK enzymes to therapeutic effectiveness is not currently known.1
AD, atopic dermatitis; IL, interleukin; JAK, Janus kinase; STAT, signal transducer and activator of transcription proteins; Th2, T helper 2; TSLP, thymic stromal lymphopoietin.
HOW OPZELURA WORKS: THE ONE-OF-A-KIND TOPICAL JAK INHIBITOR FOR UNCONTROLLED, MILD TO MODERATE ATOPIC DERMATITIS IN NON-IMMUNOCOMPROMISED ADULT AND PEDIATRIC PATIENTS AGED ≥12 YEARS
INDICATION AND IMPORTANT SAFETY INFORMATION FOR OPZELURA
OPZELURA is indicated for the topical short-term and non-continuous chronic treatment of mild to moderate atopic dermatitis in non-immunocompromised adult and pediatric patients 12 years of age and older whose disease is not adequately controlled with topical prescription therapies or when those therapies are not advisable.
Use of OPZELURA in combination with therapeutic biologics, other JAK inhibitors, or potent immunosuppressants such as azathioprine or cyclosporine is not recommended.
Please see additional Important Safety Information at the end of this video and Full Prescribing Information, including Boxed Warning, and Medication Guide for OPZELURA, at OpzeluraHCP.com.
DYSREGULATION OF THE JAK-STAT PATHWAY IN AD
Atopic dermatitis, also known as AD, is a chronic skin disease marked by inflammation, itch, and skin barrier dysfunction.
It is believed to be caused by the dysregulation of many inflammatory cytokines and immune mediators.
These cytokines, IL-4, IL-13, IL-31, and TSLP, are thought to help perpetuate the cycle of inflammation and itch that characterize AD.
JAKs are intracellular signaling enzymes that act downstream of these cytokines and therefore are believed to play a key role in AD itch and inflammation.
OPZELURA: FIRST AND ONLY TOPICAL JAK INHIBITOR FOR THE TREATMENT OF MILD TO MODERATE AD
OPZELURA is the first and only FDA-approved topical JAK inhibitor.
It is a treatment that can be applied to affected skin, including sensitive locations such as the periorbital and intertriginous areas. OPZELURA is available in a nongreasy, nonsteroidal cream formulation. For topical use only. Not for ophthalmic, oral, or intravaginal use.
In clinical trials, OPZELURA was studied as a monotherapy in adult and pediatric patients 12 years of age and older.
As the first and only FDA-approved topical JAK inhibitor, OPZELURA works differently from other topical AD treatment options.
OPZELURA is a topical JAK inhibitor designed to target the JAK-STAT pathway, thereby helping to regulate the signaling of key cytokines believed to be involved in AD.
Remember, the key cytokines that are thought to be critical to the Th2 response of AD include IL-4, IL-13, IL-31, and TSLP.
OPZELURA directly targets the JAK-STAT pathway, mediating the signaling of key cytokines involved in itch and inflammation. OPZELURA presents a promising treatment option for patients with mild to moderate AD.
IMPORTANT SAFETY INFORMATION
Patients treated with oral Janus kinase inhibitors for inflammatory conditions are at risk for developing serious infections that may lead to hospitalization or death. Reported infections include:
- Active tuberculosis, which may present with pulmonary or extrapulmonary disease.
- Invasive fungal infections, including cryptococcosis and pneumocystosis.
- Bacterial, viral, including herpes zoster, and other infections due to opportunistic pathogens.
Avoid use of OPZELURA in patients with an active, serious infection, including localized infections. If a serious infection develops, interrupt OPZELURA until the infection is controlled. Carefully consider the benefits and risks of treatment prior to initiating OPZELURA in patients with chronic or recurrent infection. Closely monitor patients for the development of signs and symptoms of infection during and after treatment with OPZELURA.
Serious lower respiratory tract infections were reported in the clinical development program with topical ruxolitinib.
No cases of active tuberculosis (TB) were reported in clinical trials with OPZELURA. Cases of active TB were reported in clinical trials of oral Janus kinase inhibitors used to treat inflammatory conditions. Consider evaluating patients for latent and active TB infection prior to administration of OPZELURA. During OPZELURA use, monitor patients for the development of signs and symptoms of TB.
Viral reactivation, including cases of herpes virus reactivation (e.g., herpes zoster), were reported in clinical trials with Janus kinase inhibitors used to treat inflammatory conditions including OPZELURA. If a patient develops herpes zoster, consider interrupting OPZELURA treatment until the episode resolves.
Hepatitis B viral load (HBV-DNA titer) increases, with or without associated elevations in alanine aminotransferase and aspartate aminotransferase, have been reported in patients with chronic HBV infections taking oral ruxolitinib. OPZELURA initiation is not recommended in patients with active hepatitis B or hepatitis C.
In a large, randomized, postmarketing safety study in rheumatoid arthritis (RA) patients 50 years of age and older with at least one cardiovascular risk factor comparing an oral JAK inhibitor to tumor necrosis factor (TNF) blocker treatment, a higher rate of all-cause mortality, including sudden cardiovascular death, was observed with the JAK inhibitor.
Consider the benefits and risks for the individual patient prior to initiating or continuing therapy with OPZELURA.
Malignancies were reported in patients treated with OPZELURA. Lymphoma and other malignancies have been observed in patients receiving JAK inhibitors used to treat inflammatory conditions. In RA patients treated with an oral JAK inhibitor, a higher rate of malignancies (excluding non-melanoma skin cancer (NMSC)) was observed when compared with TNF blockers. Patients who are current or past smokers are at additional increased risk.
Consider the benefits and risks for the individual patient prior to initiating or continuing therapy with OPZELURA, particularly in patients with a known malignancy (other than successfully treated non-melanoma skin cancers), patients who develop a malignancy when on treatment, and patients who are current or past smokers.
Non-melanoma skin cancers, including basal cell and squamous cell carcinoma, have occurred in patients treated with OPZELURA. Perform periodic skin examinations during OPZELURA treatment and following treatment as appropriate. Exposure to sunlight and UV light should be limited by wearing protective clothing and using broad-spectrum sunscreen.
MAJOR ADVERSE CARDIOVASCULAR EVENTS (MACE)
In RA patients 50 years of age and older with at least one cardiovascular risk factor treated with an oral JAK inhibitor, a higher rate of major adverse cardiovascular events (MACE) (defined as cardiovascular death, myocardial infarction, and stroke), was observed when compared with TNF blockers. Patients who are current or past smokers are at additional increased risk. Discontinue OPZELURA in patients who have experienced a myocardial infarction or stroke.
Consider the benefits and risks for the individual patient prior to initiating or continuing therapy with OPZELURA, particularly in patients who are current or past smokers and patients with other cardiovascular risk factors. Patients should be informed about the symptoms of serious cardiovascular events and the steps to take if they occur. Discontinue OPZELURA in patients that have experienced a myocardial infarction or stroke.
Thromboembolic events were observed in trials with OPZELURA. Thrombosis, including pulmonary embolism (PE), deep venous thrombosis (DVT), and arterial thrombosis have been reported in patients receiving JAK inhibitors used to treat inflammatory conditions. Many of these adverse reactions were serious and some resulted in death. In RA patients 50 years of age and older with at least one cardiovascular risk factor treated with an oral JAK inhibitor, a higher rate of thrombosis was observed when compared with TNF blockers. Avoid OPZELURA in patients at risk. If symptoms of thrombosis occur, discontinue OPZELURA and treat appropriately.
Thrombocytopenia, Anemia, and Neutropenia
Thrombocytopenia, anemia, and neutropenia were reported in the clinical trials with OPZELURA. Consider the benefits and risks for individual patients who have a known history of these events prior to initiating therapy with OPZELURA. Perform CBC monitoring as clinically indicated. If signs and/or symptoms of clinically significant thrombocytopenia, anemia, and neutropenia occur, patients should discontinue OPZELURA.
Treatment with oral ruxolitinib has been associated with increases in lipid parameters including total cholesterol, low-density lipoprotein (LDL) cholesterol, and triglycerides.
In atopic dermatitis, the most common adverse reactions (≥1%) are nasopharyngitis (3%), diarrhea (1%), bronchitis (1%), ear infection (1%), eosinophil count increased (1%), urticaria (1%), folliculitis (1%), tonsillitis (1%), and rhinorrhea (1%).
There is a pregnancy registry that monitors pregnancy outcomes in pregnant persons exposed to OPZELURA during pregnancy. Pregnant persons exposed to OPZELURA and healthcare providers should report OPZELURA exposure by calling 1-855-463-3463.
Advise women not to breastfeed during treatment with OPZELURA and for approximately four weeks after the last dose (approximately 5-6 elimination half-lives).
Please see Full Prescribing Information, including Boxed Warning, and Medication Guide for OPZELURA, at OpzeluraHCP.com.
|KEY CYTOKINES IN ATOPIC DERMATITIS4,5|
|Promotes the differentiation of Th2 cells, which in turn produces more proinflammatory cytokines|
|Interrupt production of skin barrier proteins, causing further inflammation and barrier dysfunction|
|Generated in part from keratinocyte stimulation, activate T-cells, leading to further cytokine production|
AD, atopic dermatitis; IL, interleukin; JAK, Janus kinase; Th2, T helper 2; TSLP, thymic stromal lymphopoietin.