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Investigating the effectiveness of different doses of oral baracinitnib in the treatment of moderate to severe atopic dermatitis (eczema)
Publication year - 2020
Publication title -
british journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.304
H-Index - 179
eISSN - 1365-2133
pISSN - 0007-0963
DOI - 10.1111/bjd.19276
Subject(s) - atopic dermatitis , medicine , dermatology , citation , janus kinase , family medicine , immunology , library science , cytokine , computer science
Atopic dermatitis (AD), also commonly called eczema, is an inflammatory itchy skin disease especially common worldwide in children but also in adults. Kinases are enzymes that are important to many roles of cells within the body, and the Janus Kinase (JAK) pathway plays a role in inflammation. In recent years, medicines that inhibit this pathway have been developed, with potential benefit in inflammatory skin diseases such as eczema. Baracitinib is an orally (taken by mouth) active inhibitor of JAK which is not yet licensed for general use for eczema. It is currently being investigated in phase III trials as a potential treatment for AD. This international study was funded by Ely Lilly + Co., the manufacturers of baracitinib. It was conducted at 173 sites in Europe, Asia, Latin America and Australia, involving over 1200 patients. The study describes two independent, multicentre trials called BREEZE‐AD1 and BREEZE‐AD2. Adult volunteers qualified if they had moderate to severe AD which had not improved adequately after topical (applied to the skin) cream treatments. They were randomly assigned to once a day receive either a dummy drug (placebo) or baricitinib 1 mg, 2 mg, or 4 mg, for 16 weeks. Neither the patients nor the investigators knew which treatment the patients were receiving. Patients were assessed by a variety of scoring systems which, for example, measure changes in itch, night disturbance, skin pain and quality of life. Improvements in the Investigator Global Assessment Score were analysed statistically. Potential adverse events (unwanted side effects) were recorded. The results showed that baricitinib improved the signs and symptoms in patients with moderate to severe AD within 16 weeks of treatment. Itch reduced rapidly, especially with the higher 4mg and 2mg doses, and there was reduced skin pain and decreased night awakenings. The commonest side effects were sore throat and headache, similar to those seen in earlier trials. No new significant safety concerns were identified. Linked Article:   Simpson et al. Br J Dermatol 2020; 183 :242–255.

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