Study of Ruxolitinib Cream in Adolescents With Atopic Dermatitis

The purpose of this study is to evaluate the long-term safety and tolerability of ruxolitinib cream in adolescents with Atopic Dermatitis (AD).

The study comprises of a 8 week continuous treatment period followed by 44 week Long Term Safety (LTS) period and 30 days safety follow up period. During Continuous treatment period all lesions identified at baseline will be treated and during LTS period only active lesions will be treated.

Eligibility Criteria:
Inclusion Criteria:

* A diagnosis of Atopic Dermatitis (AD) as defined by the Hanifin and Rajka (1980) criteria.
* Duration of AD of at least 2 years.
* Total IGA score of 2 to 3 at the screening and baseline visits.
* Percent BSA (excluding the scalp) with AD involvement of 3% to 20% at the screening and baseline visits.
* Atopic dermatitis not adequately controlled with other topical prescription therapies or when those therapies are not advisable.
* Agree to discontinue all agents used to treat AD from screening through the final follow up visit.
* Willingness to avoid pregnancy or fathering children.

Exclusion Criteria:

* An unstable course of AD (spontaneously improving or rapidly deteriorating) as determined by the investigator in the 4 weeks prior to baseline.
* Concurrent conditions and history of other diseases
* Any current and/or history of serious illness or medical, physical, or psychiatric condition(s) that, in the investigator's opinion, would interfere with full participation in the study, including application of study cream and attending required study visits; pose a significant risk to the participant; or interfere with interpretation of study data. For example:
* Clinically significant or uncontrolled cardiovascular disease, including unstable angina, acute myocardial infarction or stroke within 6 months from Day 1 of study cream application, New York Heart Association Class III or IV congestive heart failure, and arrhythmia requiring therapy or uncontrolled hypertension (blood pressure \> 150/90 mm Hg) unless approved by the medical monitor/sponsor.
* Current and/or history of malignancy in the 5 years preceding the baseline visit, except for adequately treated, nonmetastatic nonmelanoma skin cancer.
* Current and/or history of arterial or venous thrombosis, including DVT and PE.
* Current and/or history of active tuberculosis or current and/or history of latent tuberculosis unless adequately treated.
* Any of the following clinical laboratory test results at screening:

  1. Hemoglobin \< 100 g/L (\< 10 g/dL)
  2. Liver function tests:
* AST or ALT ≥ 2.5 × ULN
* Total bilirubin \> 1.5 × ULN with the exception of Gilbert disease. c. Estimated glomerular filtration rate \< 30 mL/min/1.73 m2 (using the CKD Epidemiology Collaboration equation).

  d. Positive serology test results for HIV antibody. e. Any other clinically significant laboratory result that, in the opinion of the investigator, poses a significant risk to the participant.
* Use of any of the following treatments within the indicated washout period before baseline:

  1. 5 half-lives or 12 weeks, whichever is longer - biologic agents (eg, dupilumab).
  2. 4 weeks - systemic corticosteroids or adrenocorticotropic hormone analogues, cyclosporine, methotrexate, azathioprine, or other systemic immunosuppressive or immunomodulating agents (eg, mycophenolate or tacrolimus).
  3. 2 weeks - immunizations with live-attenuated vaccines; sedating antihistamines, unless on long-term stable regimen (nonsedating antihistamines are permitted).

     Note: Live-attenuated vaccines are not recommended during the CT period. Note: COVID-19 vaccination is allowed.
  4. 1 week - use of other topical treatments for AD (other than bland emollients, eg, Aveeno® creams, ointments, sprays, soap substitutes), such as topical antipruritics (eg, doxepin cream), corticosteroids, calcineurin inhibitors, PDE4 inhibitors, coal tar (shampoo), antibiotics, or antibacterial cleansing body wash/soap.

Note: Diluted sodium hypochlorite "bleach" baths are allowed as long as they do not exceed 2 baths per week and their frequency remains the same throughout the study.

* Previously received systemic or topical JAK inhibitors (eg, ruxolitinib, tofacitinib, baricitinib, filgotinib, lestaurtinib, pacritinib).
* Ultraviolet light therapy or prolonged exposure to natural or artificial sources of UV radiation (eg, sunlight or tanning booth) within 2 weeks prior to the baseline visit and/or intention to have such exposure during the study, which is thought by the investigator to potentially impact the participant's AD.
* Current treatment or treatment within 30 days or 5 half-lives (whichever is longer) before baseline with another investigational medication or current enrollment in another investigational drug protocol.
* Current treatment or treatment within 30 days or 5 half-lives (whichever is longer) before baseline with a strong CYP3A4 inhibitor.
* Inability to draw blood for PK analysis from any nonlesional areas.
* Known allergy or reaction to any component of the study cream formulation.
* In the opinion of the investigator unable or unlikely to comply with the administration schedule and study evaluations.

Further exclusion criteria may apply.