Regulatory & Policy

FDA approves Lisraya as first targeted therapy for dermatomyositis

FDA approves Lisraya as first targeted therapy for dermatomyositis

The US FDA has approved Lisraya (brepocitinib) 30 mg for the treatment of adults with dermatomyositis, making it the first targeted therapy approved for the rare systemic autoimmune disease. Roivant Sciences (Nasdaq: ROIV) and its subsidiary Priovant Therapeutics received the approval, which carries no restrictions on disease activity level, clinical presentation, or prior treatment experience.

Lisraya is administered as a once-daily oral pill. The label includes a boxed warning covering serious infections, mortality, malignancy, major adverse cardiovascular events, and thrombosis — consistent with the broader JAK inhibitor class. It is not recommended in combination with other JAK inhibitors, TYK2 inhibitors, or biologic disease-modifying antirheumatic drugs (DMARDs), nor in patients with severe hepatic or renal impairment. The FDA had previously granted Priority Review and Orphan Drug Designation for the application, as reported following NDA acceptance in March 2026.

The approval was supported by the Phase III VALOR trial, described by the company as the largest dermatomyositis clinical trial ever conducted. The primary endpoint was the myositis Total Improvement Score (TIS), a composite measure across multiple disease domains. At 52 weeks, 55% of brepocitinib-treated patients achieved moderate or better TIS improvement alongside minimal or no steroid use, compared with 30% on placebo. Among patients on corticosteroids at baseline, 62% tapered to minimal or no steroid use by week 52 versus 38% on placebo; 45% discontinued corticosteroids entirely compared with 29% on placebo. Primary results were published in the New England Journal of Medicine in March 2026, with skin-specific secondary endpoints published in JAMA Dermatology in August 2026.

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Brepocitinib is a first-in-class dual TYK2/JAK1 inhibitor designed to block multiple inflammatory cytokine pathways implicated in dermatomyositis, including type I interferon signaling. Its preferential inhibition of TYK2 and JAK1 over JAK2 and JAK3 differentiates it from broader JAK inhibitors. The molecule was originally developed by Pfizer as PF-06700841 before being licensed to Priovant at the company's formation in 2021, with Pfizer retaining a 25% equity stake in Priovant.

Lisraya enters a disease area with no previously approved targeted therapy, where clinical practice has relied on corticosteroids, non-specific immunomodulators, and intravenous immunoglobulin. In the pipeline, Cartesian Therapeutics' mRNA CAR-T asset Descartes-08 is in a Phase II TRITON trial in dermatomyositis and antisynthetase syndrome, representing a distinct cellular therapy approach in the same indication. Roivant said brepocitinib is also in late-stage development for non-infectious uveitis, cutaneous sarcoidosis, and lichen planopilaris.


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