Povorcitinib Rapidly Reduces Hives and Itch in Chronic Spontaneous Urticaria
In a phase 2, randomized, double-blind trial, the selective oral JAK1 inhibitor povorcitinib significantly reduced hives and itch severity in patients with chronic spontaneous urticaria (CSU) refractory to second-generation H1-antihistamines. Exploratory endpoints from this 136-patient study suggest clinically meaningful improvements with rapid onset, according to the abstract presented at the American College of Allergy, Asthma & Immunology 2025 Annual Scientific Meeting.
At baseline, weekly Hives Severity Score (HSS7) and Itch Severity Score (ISS7) were similar across all groups. At week 12, povorcitinib at both 45 mg and 75 mg doses demonstrated superior efficacy compared with placebo. Mean change in HSS7 from baseline was −10.9 with both 45 mg and 75 mg, versus −8.5 with placebo. For ISS7, mean reductions were −11.8 and −12.0, respectively, versus −10.0 with placebo.
Notably, the percentage of patients achieving complete resolution (score of 0) was higher with povorcitinib. At 75 mg, 50.0% of patients achieved HSS7 = 0 and 53.3% achieved ISS7 = 0, compared with 34.8% in the placebo group. The 45 mg group showed similar results.
Patients receiving povorcitinib also reached the minimally important difference (MID, ≥5-point improvement) faster than placebo. Median days to HSS7 MID were 15.5 (15 mg), 14.0 (45 mg), and 10.0 (75 mg) versus 36.0 with placebo. For ISS7, median days to MID were 15.5, 10.5, and 9.0 versus 33.0 with placebo.
“Povorcitinib markedly and rapidly reduced hives and itch,” the investigators stated. “These findings support its potential as an early treatment option for CSU inadequately controlled by second-generation H1-antihistamines.”
All 3 povorcitinib doses were well tolerated, with no safety signals observed over the 12-week evaluation period. These results underscore povorcitinib’s promise in the CSU treatment landscape, particularly in patients with persistent symptoms despite antihistamine therapy.
Reference
Povorcitinib demonstrates rapid improvement in hives and itch in patients with chronic spontaneous urticaria (CSU). News Release. presented at: American College of Allergy, Asthma & Immunology 2025 Annual Scientific Meeting; November 6-10, 2025; Orlando, FL.
