Pooled safety analysis of baricitinib in adult patients with atopic dermatitis from 8 randomized clinical trials.


Journal

Journal of the European Academy of Dermatology and Venereology : JEADV
ISSN: 1468-3083
Titre abrégé: J Eur Acad Dermatol Venereol
Pays: England
ID NLM: 9216037

Informations de publication

Date de publication:
Feb 2021
Historique:
received: 10 08 2020
accepted: 07 09 2020
pubmed: 15 9 2020
medline: 15 5 2021
entrez: 14 9 2020
Statut: ppublish

Résumé

Janus kinase (JAK) inhibition is a new mode of action in atopic dermatitis (AD); clarity about drug class safety considerations in the context of AD is important. Baricitinib, an oral, reversible, selective inhibitor of JAK1/JAK2, is in late-stage development for adult patients with moderate-to-severe AD. To report pooled safety data for baricitinib in patients with moderate-to-severe AD in the clinical development program including long-term extension (LTE) studies. This analysis included patient-level safety data from six double-blinded, randomized, placebo-controlled studies (one phase 2 and five phase 3), one double-blinded, randomized, LTE study and one open-label LTE study, reported in three data sets: placebo-controlled, 2-mg - 4-mg extended and All-bari AD. Safety outcomes include treatment-emergent adverse events, adverse events of special interest and abnormal laboratory changes. Proportions of patients with events and incidence rates were calculated. Data were collected for 2531 patients who were given baricitinib for 2247 patient-years (median duration 310 days). The frequency of serious infections, opportunistic infections and conjunctival disorders was low and similar between treatment groups in the placebo-controlled period. The most common serious infections were eczema herpeticum [n = 11, incidence rates (IR) = 0.5], cellulitis (n = 6, IR = 0.3) and pneumonia (n = 3, IR = 0.1). There were four opportunistic infections (IR = 0.2). No malignancies, gastrointestinal perforations, positively adjudicated cardiovascular events or tuberculosis were reported in the placebo-controlled period in baricitinib-treated patients. Frequency of herpes simplex was higher in the 4-mg group (6.1%) vs. the 2-mg (3.6%) and placebo group (2.7%); IRs in the extended data set (2-mg IR = 9.6; 4-mg IR = 14.5) were lower vs. the placebo-controlled data set (2-mg IR = 12.4; 4-mg IR = 21.3). In the All-bari AD data set, there were two positively adjudicated major adverse cardiovascular events (2-mg group): two venous thrombosis events (4-mg group) and one death. This integrated safety analysis in patients with moderate-to-severe AD confirms the established safety profile of baricitinib.

Sections du résumé

BACKGROUND BACKGROUND
Janus kinase (JAK) inhibition is a new mode of action in atopic dermatitis (AD); clarity about drug class safety considerations in the context of AD is important. Baricitinib, an oral, reversible, selective inhibitor of JAK1/JAK2, is in late-stage development for adult patients with moderate-to-severe AD.
OBJECTIVE OBJECTIVE
To report pooled safety data for baricitinib in patients with moderate-to-severe AD in the clinical development program including long-term extension (LTE) studies.
METHODS METHODS
This analysis included patient-level safety data from six double-blinded, randomized, placebo-controlled studies (one phase 2 and five phase 3), one double-blinded, randomized, LTE study and one open-label LTE study, reported in three data sets: placebo-controlled, 2-mg - 4-mg extended and All-bari AD. Safety outcomes include treatment-emergent adverse events, adverse events of special interest and abnormal laboratory changes. Proportions of patients with events and incidence rates were calculated.
RESULTS RESULTS
Data were collected for 2531 patients who were given baricitinib for 2247 patient-years (median duration 310 days). The frequency of serious infections, opportunistic infections and conjunctival disorders was low and similar between treatment groups in the placebo-controlled period. The most common serious infections were eczema herpeticum [n = 11, incidence rates (IR) = 0.5], cellulitis (n = 6, IR = 0.3) and pneumonia (n = 3, IR = 0.1). There were four opportunistic infections (IR = 0.2). No malignancies, gastrointestinal perforations, positively adjudicated cardiovascular events or tuberculosis were reported in the placebo-controlled period in baricitinib-treated patients. Frequency of herpes simplex was higher in the 4-mg group (6.1%) vs. the 2-mg (3.6%) and placebo group (2.7%); IRs in the extended data set (2-mg IR = 9.6; 4-mg IR = 14.5) were lower vs. the placebo-controlled data set (2-mg IR = 12.4; 4-mg IR = 21.3). In the All-bari AD data set, there were two positively adjudicated major adverse cardiovascular events (2-mg group): two venous thrombosis events (4-mg group) and one death.
CONCLUSION CONCLUSIONS
This integrated safety analysis in patients with moderate-to-severe AD confirms the established safety profile of baricitinib.

Identifiants

pubmed: 32926462
doi: 10.1111/jdv.16948
doi:

Substances chimiques

Azetidines 0
Pharmaceutical Preparations 0
Purines 0
Pyrazoles 0
Sulfonamides 0
baricitinib ISP4442I3Y

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

476-485

Subventions

Organisme : Incyte
Organisme : Eli Lilly and Company

Informations de copyright

© 2020 The Authors. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.

Références

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Auteurs

T Bieber (T)

University Hospital of Bonn, Bonn, Germany.

J P Thyssen (JP)

Department of Dermatology and Allergy, Herlev-Gentofte Hospital University of Copenhagen, Copenhagen, Denmark.

K Reich (K)

University Med Cen Hamburg-Eppendorf, Hamburg, Germany.

E L Simpson (EL)

Oregon Health & Science University, Portland, OR, USA.

N Katoh (N)

Department of Dermatology, Kyoto Prefectural University of Medicine, Kyoto, Japan.

A Torrelo (A)

Department of Dermatology, Hospital Infantil Universitario Niño Jesús, Madrid, Spain.

M De Bruin-Weller (M)

UMC Utrecht, Utrecht, the Netherlands.

D Thaci (D)

Comprehensive Center for Inflammation Medicine, University Hospital Schleswig Holstein, Luebeck, Germany.

R Bissonnette (R)

Innovaderm Research, Montreal, QC, Canada.

M Gooderham (M)

SKiN Centre for Dermatology, Peterborough, ON, Canada.

J Weisman (J)

Medical Dermatology Specialists, Atlanta, GA, USA.

F Nunes (F)

Eli Lilly and Company, Indianapolis, IN, USA.

D Brinker (D)

Eli Lilly and Company, Indianapolis, IN, USA.

M Issa (M)

Eli Lilly and Company, Indianapolis, IN, USA.

K Holzwarth (K)

Eli Lilly and Company, Indianapolis, IN, USA.

M Gamalo (M)

Eli Lilly and Company, Indianapolis, IN, USA.

E Riedl (E)

Eli Lilly and Company, Indianapolis, IN, USA.

J Janes (J)

Eli Lilly and Company, Indianapolis, IN, USA.

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