• Eric L Simpson, Seth Forman, Jonathan I Silverberg, Matthew Zirwas, Emanual Maverakis, George Han, Emma Guttman-Yassky, Daniel Marnell, Robert Bissonnette, Jill Waibel, Fabio P Nunes, Amy M DeLozier, Robinette Angle, Margaret Gamalo, Katrin Holzwarth, Orin Goldblum, Jinglin Zhong, Jonathan Janes, and Kim Papp.
• Oregon Health and Science University, Portland, Oregon. Electronic address: simpsone@ohsu.edu.
• J. Am. Acad. Dermatol. 2021 Jul 1; 85 (1): 62-70.

BackgroundBaricitinib, an oral selective Janus kinase 1/Janus kinase 2 inhibitor, is being studied for moderate-to-severe atopic dermatitis (AD) in adults.ObjectiveTo evaluate the efficacy and safety of baricitinib monotherapy in a North American phase 3 trial (BREEZE-AD5/NCT03435081) of adults with moderate-to-severe AD who responded inadequately or were intolerant to topical therapy.MethodsPatients (N = 440) were randomized 1:1:1 to once-daily placebo or baricitinib (1 mg or 2 mg). The primary endpoint was the proportion of patients achieving ≥75% reduction in the Eczema Area and Severity Index at week 16. A key secondary endpoint was the proportion of patients achieving a validated Investigator Global Assessment for AD score of 0 (clear)/1(almost clear) with ≥2-point improvement.ResultsAt week 16, the proportion of patients achieving Eczema Area and Severity Index was 8%, 13%, and 30% (P < .001, 2 mg vs placebo) and those with a validated Investigator Global Assessment for AD score of 0/1 were 5%, 13%, and 24% (P < .001, 2 mg vs placebo) for placebo, baricitinib 1 mg, and baricitinib 2 mg, respectively. Safety findings were similar to those of other baricitinib AD studies.LimitationsShort-term clinical trial results may not be generalizable to real-world settings.ConclusionBaricitinib was efficacious for patients with moderate-to-severe AD with no new safety findings over 16 weeks.Copyright © 2021. Published by Elsevier Inc.

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