Study on new treatment for dermatomyositis commented on by researcher at KI
In an editorial in The New England Journal of Medicine, Ingrid Lundberg at Karolinska Institutet comments on a phase 3 trial of the drug brepocitinib in adults with dermatomyositis. The editorial describes improved symptoms in the trial, but also highlights limitations and questions that remain.
Dermatomyositis is an autoimmune disease that mainly affects muscles and skin, but it can also involve other organs, including the lungs. It is often treated with high doses of glucocorticoids (steroids). However, many patients continue to have inflammation despite treatment.
Results point to possible benefit
The editorial discusses the VALOR trial, a double-blind, randomised, placebo-controlled study including 241 adults with dermatomyositis at more than 90 sites in 20 countries. Participants received brepocitinib 30 mg, brepocitinib 15 mg or placebo once daily for 52 weeks. Brepocitinib blocks TYK2 and JAK1, proteins involved in cytokine signalling. The editorial links this to interferon pathways, meaning immune signalling routes controlled by interferons, proteins that help regulate inflammation.
Patients in the 30 mg group improved after four weeks. At week 52, they had a Total Improvement Score of 46.5. This score ranges from 0 to 100, with higher scores showing greater improvement. A score of 40 or more is classified as moderate improvement.
“Targeting interferon pathways that appear to be involved in dermatomyositis is an important strength of the study. At the same time, the effect on muscle strength and on more severe forms of disease still needs to be clarified,” says Professor Ingrid Lundberg at the Department of Medicine, Solna.
The editorial also notes that relatively few patients had interstitial lung disease (ILD), which may mean that patients with less severe disease were overrepresented. The material provided does not include information on collaborators, funding or potential conflicts of interest.
Editorial
"A Phase 3 Trial of Brepocitinib in Dermatomyositis", Ingrid E. Lundberg. The New England Journal of Medicine, online 13 May 2026, doi: 10.1056/NEJMe2604009.