New Data Support Delgocitinib for Sensitive Skin Areas

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Facial and neck involvement in atopic dermatitis (AD) presents distinct therapeutic challenges due to the area’s thin, sensitive skin, and high visibility, which heighten both the risk and impact of treatment-related adverse events. While topical corticosteroids remain the first-line option for managing flares, their long-term use in these areas is constrained by risks including atrophy, telangiectasia, and periorificial dermatitis—factors that frequently contribute to reduced adherence.¹ Calcineurin inhibitors such as tacrolimus offer a steroid-sparing alternative with lower risk of skin thinning, but are often limited by local irritation, slower onset of action, and regulatory restrictions tied to age and site of use. As a result, there remains an unmet need for effective, well-tolerated topical therapies suitable for chronic use on cosmetically sensitive sites.²

To address this, novel topical agents such as delgocitinib ointment—a topical Janus kinase (JAK) inhibitor—have emerged as potential therapeutic options. Approved in Japan in 2020, delgocitinib inhibits all 4 JAK family kinases (JAK1, JAK2, JAK3, and TYK2), offering targeted suppression of inflammatory pathways implicated in AD.³

A recent 12-week, open-label, multicenter clinical study conducted in Japan evaluated the efficacy, safety, and treatment satisfaction associated with switching from topical steroids or tacrolimus ointment to delgocitinib ointment in adult patients with AD-related facial or neck lesions. The study enrolled 40 patients (38 in the efficacy analysis), all of whom had used topical corticosteroids or tacrolimus ointment for ≥3 months and had either experienced or were concerned about local adverse effects.³

Results

The primary endpoint, change in treatment satisfaction as measured by the Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9), showed significant improvement across all domains: effectiveness, convenience, and global satisfaction. Notably, mean global satisfaction scores increased from 58.8 at baseline to 73.2 at week 12. Internal consistency reliability of the TSQM-9 subscales also improved over time, suggesting enhanced patient-perceived value of the new treatment.

Secondary outcomes further supported these findings. Significant reductions were observed in disease severity as measured by the modified Eczema Area and Severity Index (mEASI), EASI scores, and Numerical Rating Scale (NRS) for pruritus. The Atopic Dermatitis Control Tool (ADCT) scores also improved, indicating better overall disease control.

Importantly, a reduction in local adverse effects previously associated with corticosteroids and tacrolimus ointment was noted. Among patients previously treated with corticosteroids, the proportion experiencing skin atrophy and telangiectasia declined over the course of treatment with delgocitinib. Similarly, irritation and pruritus related to tacrolimus use also improved. These changes were corroborated by patient-reported outcomes indicating better skin feel, firmness, appearance, and reduced dryness.

Only 1 mild adverse event (aggravation of acne vulgaris) was reported, suggesting a favorable safety profile. Delgocitinib’s low systemic absorption, supported by prior pharmacokinetic studies, reinforces its safety when used in localized applications.

Conclusion

The study does have limitations. Its small sample size and short duration limit the generalizability and long-term applicability of the findings. Furthermore, more rigorous analyses are required to explore correlations between clinical severity indices and patient satisfaction scores.

Nevertheless, these findings support delgocitinib ointment as a viable treatment alternative for facial and neck AD, particularly in patients experiencing adverse effects from or nonadherence to corticosteroids or tacrolimus ointment. Its efficacy, improved tolerability, and patient preference profile position it as a promising option for targeted topical therapy. Future research should examine its role in combination or proactive treatment regimens, and assess its effectiveness in broader populations, including those with dupilumab-associated head and neck erythema.

References

1. Saeki H, Ohya Y, Furuta J, et al. English version of clinical practice guidelines for the management of atopic dermatitis 2021. J Dermatol. 2022 Oct;49(10):e315-e375. doi: 10.1111/1346-8138.16527. Epub 2022 Aug 22. PMID: 35996152.
2. Saeki H. Guidelines for the management of atopic dermatitis 2024. Arerugi. 2024;73(9):1025-1125. doi:10.15036/arerugi.73.1025
3. Abe M, Igarashi A, Kitajima H, Toyama H, Kabashima K, Saeki H. Treatment satisfaction, efficacy, and safety of delgocitinib ointment for atopic dermatitis-induced rash on the face and neck: Efficacy at reducing local side effects of topical steroid and tacrolimus ointment. J Dermatol. 2025 Jun 26. doi: 10.1111/1346-8138.17817. Epub ahead of print. PMID: 40566983.