Baricitinib Rapidly Improves Skin Pain Resulting in Improved Quality of Life for Patients with Atopic Dermatitis: Analyses from BREEZE-AD1, 2, and 7

Abstract

Introduction: Skin pain (described as discomfort or soreness) is increasingly recognized as a symptom of atopic dermatitis which impacts patient quality of life. This analysis examined the effect of baricitinib on skin pain in atopic dermatitis in three phase 3 studies (BREEZE-AD1, -AD2, and -AD7). Methods: Patients were randomly assigned 2:1:1:1 to receive once-daily placebo, baricitinib 1 mg, 2 mg, or 4 mg in BREEZE-AD1 (N = 624) and -AD2 (N = 615) and 1:1:1 to receive oncedaily placebo, baricitinib 2 mg, or 4 mg, with topical corticosteroids, in BREEZE-AD7 (N = 329) for 16 weeks. Patients recorded their skin pain severity using the Skin Pain Numerical Rating Scale (NRS) via an electronic daily diary. Data were analyzed by study as least squares mean change from baseline in daily scores for the randomly assigned patients using mixed model repeated measures analysis. Analysis of

JAK inhibition and the holy grail for pain control in early RA

“…A superior efficacy of baricitinib with regard to more rapid improvement of pain was also brought forward in more advanced RA as well as for other JAK-inhibitors (JAKi) in comparison to TNF blockade or IL-6 inhibition 2 3. In other inflammatory diseases, comparable findings have been reported 4 5. Pain control is a highly preferred outcome in RA especially in early disease where aspects of chronicity and negative illness behaviour have not had the chance yet to fully develop, as was demonstrated in a study from our group 6.…”

Patient preferences for atopic dermatitis medications in the UK, France and Spain: a discrete choice experiment

“…Treatment attributes and levels included in the DCE were identified through a targeted literature review of Embase and MEDLINE for quantitative and qualitative preference studies and a review of product labels for AD treatments (search conducted 10 September 2018; see online supplemental methods and table 1 for details). The attribute levels included in the DCE (eg, likelihood of achieving clear or almost clear skin at week 16) were informed by clinical data from product labels for AD treatments (where available), including both baricitinib and dupilumab, reflecting the range of potential experiences that patients may have 19 20. Attributes included the following: chance of achieving clear or almost clear skin at week 16, chance of achieving a meaningful reduction in itch at week 16, risk of eye inflammation, risk of serious infections, administration, flare management, long-term disease management, monitoring and speed of onset (table 1).…”

Baricitinib Safety for Events of Special Interest in Populations at Risk: Analysis from Randomised Trial Data Across Rheumatologic and Dermatologic Indications

“…Therefore, it is important to provide access to treatments with a better long-term benefit–risk balance, including dupilumab and JAKi indicated for AD [ 60 , 61 ]. Baricitinib has been shown in clinical trials to have fast onset of action, especially on the most limiting AD symptom itch, which is also recognised in the recently published EuroGuiDerm 2022 guideline on atopic eczema (atopic dermatitis) [ 59 ], and has been shown to be effective on AD signs and other symptoms, such as skin pain and sleep, leading to an overall improved quality of life [ 62 – 64 ]. This treatment algorithm is recommended by the European Guidelines for Treatment of AD, who recommend dupilumab and baricitinib with the same level of evidence “in atopic eczema patients who are candidates for systemic treatment”, while recommending against the long-term use of systemic glucocorticosteroids [ 59 ].…”