Impact of baricitinib in combination with topical steroids on atopic dermatitis symptoms, quality of life and functioning in adult patients with moderate-to-severe atopic dermatitis from the BREEZE-AD7 Phase 3 randomized trial.


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:
Jul 2021
Historique:
received: 11 12 2020
accepted: 17 03 2021
pubmed: 10 4 2021
medline: 22 6 2021
entrez: 9 4 2021
Statut: ppublish

Résumé

Baricitinib is an oral, selective, reversible Janus kinase 1/2 inhibitor approved in the European Union and Japan and under investigation in the United States for treatment of atopic dermatitis (AD). To evaluate the impact of baricitinib plus background topical corticosteroids (TCS) on health-related quality of life (HRQoL), how AD symptoms impact work productivity and life functioning, and treatment benefit using patient-reported outcome (PRO) assessments in patients with moderate-to-severe AD previously experiencing inadequate response to TCS. Adult patients with AD in BREEZE-AD7, a Phase 3, multicentre, double-blind trial, were randomised 1 : 1 : 1 to daily oral placebo (control) or baricitinib 4- or 2-mg plus TCS. PROs reported Week 1 through Week 16: Dermatology Life Quality Index (DLQI), Work Productivity and Activity Impairment-AD (WPAI-AD); Patient-Reported Outcomes Measurement Information System (PROMIS) Itch and Sleep measures, and Patient Benefit Index (PBI). Data were analysed using logistic regression (categorical) and mixed model repeated measures (continuous). PBI scores were analysed using analysis of variance. A total of 329 patients were randomised. Treatment with baricitinib 4-mg (N = 111) or 2 mg (N = 109) plus TCS led to rapid, statistically significant improvements [vs. TCS plus placebo (N = 109)] in DLQI ≥4-point improvement starting at Week 2 (4-mg plus TCS, P ≤ 0.001; 2-mg plus TCS P ≤ 0.05), change from baseline in WPAI-AD presenteeism at Week 1 (4-mg plus TCS, P ≤ 0.01; 2-mg plus TCS P ≤ 0.05) and PROMIS itch interference at Week 2 (4-mg plus TCS P ≤ 0.01). Improvements were sustained through Week 16 for baricitinib 4-mg. Statistically significant improvements were observed at Week 16 for PBI global score (4-mg plus TCS, P ≤ 0.001; 2-mg plus TCS P ≤ 0.05). Baricitinib plus TCS vs. placebo plus TCS showed significant improvements in treatment benefit at Week 16 and rapid significant improvements in HRQoL and impact of AD symptoms on work productivity and functioning through 16 weeks.

Sections du résumé

BACKGROUND BACKGROUND
Baricitinib is an oral, selective, reversible Janus kinase 1/2 inhibitor approved in the European Union and Japan and under investigation in the United States for treatment of atopic dermatitis (AD).
OBJECTIVES OBJECTIVE
To evaluate the impact of baricitinib plus background topical corticosteroids (TCS) on health-related quality of life (HRQoL), how AD symptoms impact work productivity and life functioning, and treatment benefit using patient-reported outcome (PRO) assessments in patients with moderate-to-severe AD previously experiencing inadequate response to TCS.
METHODS METHODS
Adult patients with AD in BREEZE-AD7, a Phase 3, multicentre, double-blind trial, were randomised 1 : 1 : 1 to daily oral placebo (control) or baricitinib 4- or 2-mg plus TCS. PROs reported Week 1 through Week 16: Dermatology Life Quality Index (DLQI), Work Productivity and Activity Impairment-AD (WPAI-AD); Patient-Reported Outcomes Measurement Information System (PROMIS) Itch and Sleep measures, and Patient Benefit Index (PBI). Data were analysed using logistic regression (categorical) and mixed model repeated measures (continuous). PBI scores were analysed using analysis of variance.
RESULTS RESULTS
A total of 329 patients were randomised. Treatment with baricitinib 4-mg (N = 111) or 2 mg (N = 109) plus TCS led to rapid, statistically significant improvements [vs. TCS plus placebo (N = 109)] in DLQI ≥4-point improvement starting at Week 2 (4-mg plus TCS, P ≤ 0.001; 2-mg plus TCS P ≤ 0.05), change from baseline in WPAI-AD presenteeism at Week 1 (4-mg plus TCS, P ≤ 0.01; 2-mg plus TCS P ≤ 0.05) and PROMIS itch interference at Week 2 (4-mg plus TCS P ≤ 0.01). Improvements were sustained through Week 16 for baricitinib 4-mg. Statistically significant improvements were observed at Week 16 for PBI global score (4-mg plus TCS, P ≤ 0.001; 2-mg plus TCS P ≤ 0.05).
CONCLUSIONS CONCLUSIONS
Baricitinib plus TCS vs. placebo plus TCS showed significant improvements in treatment benefit at Week 16 and rapid significant improvements in HRQoL and impact of AD symptoms on work productivity and functioning through 16 weeks.

Identifiants

pubmed: 33834521
doi: 10.1111/jdv.17278
pmc: PMC8251919
doi:

Substances chimiques

Azetidines 0
Purines 0
Pyrazoles 0
Steroids 0
Sulfonamides 0
baricitinib ISP4442I3Y

Types de publication

Clinical Trial, Phase III Journal Article Multicenter Study Randomized Controlled Trial

Langues

eng

Sous-ensembles de citation

IM

Pagination

1543-1552

Subventions

Organisme : Eli Lilly and Company

Informations de copyright

© 2021 Eli Lilly and Company. Journal of the European Academy of Dermatology and Venereology published by John Wiley & Sons Ltd on behalf of European Academy of Dermatology and Venereology.

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Auteurs

A Wollenberg (A)

Department of Dermatology and Allergy, Ludwig Maximillian University, Munich, Germany.

T Nakahara (T)

Department of Dermatology, Kyushu University, Fukuoka, Japan.

C Maari (C)

Division of Dermatology, Innovaderm Research and Montreal University, Montreal, Quebec, Canada.

K Peris (K)

Dermatology, Università Cattolica del Sacro Cuore and Fondazione Policlinico Agostino Gemelli - IRCCS, Rome, Italy.

P Lio (P)

Northwestern University Feinberg School of Medicine, Chicago, IL, USA.

M Augustin (M)

University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

J I Silverberg (JI)

George Washington University School of Medicine and Health Sciences, Washington, DC, USA.

M J Rueda (MJ)

Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA.

A M DeLozier (AM)

Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA.

E Pierce (E)

Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA.

F E Yang (FE)

Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA.

L Sun (L)

Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA.

S Ball (S)

Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, USA.

M Tauber (M)

Toulouse University and CHU Larrey, Toulouse, France.

C Paul (C)

Toulouse University and CHU Larrey, Toulouse, France.

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