Comparing quality of life outcomes of JAK inhibitors and biological treatments for atopic dermatitis: a systematic review and network meta-analysis

Mostafa, Niyaz; Phan, Kevin; Lai, Belinda; Smith, Saxon D

doi:10.1080/17512433.2021.1970529

Cited by 8 publications

(5 citation statements)

References 35 publications

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“…To capture therapies and associated doses most likely to be of clinical relevance, the NMA presented here included classes of targeted systemic therapies approved for or which could gain approval in the near future (namely, lebrikizumab as assessed in associated phase 3 trials) for treatment of moderate-to-severe AD. Some NMA publications additionally synthesize data across monotherapy (i.e., targeted systemic therapy or placebo without concomitant TCS or TCI use) and combotherapy (i.e., targeted systemic therapy or placebo with concomitant TCS or TCI use) trials [ 19 , 21 , 24 ]. Including both monotherapy and combotherapy trials in NMA without further adjustment may introduce heterogeneity in patient characteristics.…”

Section: Discussionmentioning

confidence: 99%

Comparative Efficacy of Targeted Systemic Therapies for Moderate-to-Severe Atopic Dermatitis without Topical Corticosteroids: An Updated Network Meta-analysis

Silverberg,

Hong,

Calimlim

et al. 2023

Dermatol Ther (Heidelb)

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Introduction The treatment landscape for moderate-to-severe atopic dermatitis (AD) continues to expand. This network meta-analysis (NMA) updates a previously conducted NMA to include data from the most recent phase 3 trials to assess the comparative efficacy of targeted systemic therapies without the addition of topical corticosteroids (TCS) and/or topical calcineurin inhibitors (TCI) in adults with moderate-to-severe AD. Methods Data from recent phase 3 monotherapy trials of lebrikizumab, ADvocate1 (NCT04146363) and ADvocate2 (NCT04178967), were included in the analyses, along with other eligible phase 3/4 randomized placebo-controlled trials for abrocitinib, baricitinib, dupilumab, tralokinumab, and upadacitinib identified through a systemic literature review in Silverberg et al. (Dermatol Ther (Heidelb) 12(5):1181–1196, 2022 ). The proportion of patients achieving Eczema Area and Severity Index (EASI) improvement ≥ 90% from baseline (EASI-90), EASI improvement ≥ 75% from baseline (EASI-75), ≥ 4-point improvement on Pruritus Numerical Rating Scale from baseline (ΔNRS ≥ 4), and Investigator Global Assessment (IGA) score of 0 or 1 (clear or almost clear) and reduction of ≥ 2 points from baseline (IGA 0/1) were evaluated using a Bayesian network meta-analysis. Results The updated NMA analyzed 13 unique placebo-controlled trials involving 7105 patients in 32 arms across 6 targeted therapies. Upadacitinib 30 mg was the most efficacious therapy across all endpoints at the primary timepoint (week 12 or 16) and at earlier timepoints, generally followed by abrocitinib 200 mg, upadacitinib 15 mg, dupilumab 300 mg, and lebrikizumab 250 mg or abrocitinib 100 mg. Baricitinib 2 mg and tralokinumab were generally ranked lower across outcomes. Conclusions Many factors need to be considered for treatment selection for AD, especially as new treatments continue to emerge. After incorporating recent placebo-controlled phase 3 data of lebrikizumab, upadacitinib 30 mg, upadacitinib 15 mg, and abrocitinib 200 mg remain the most efficacious targeted systemic therapies over 12–16 weeks of therapy in AD. These updated findings can help healthcare providers when creating a patient’s personalized treatment plan. Supplementary Information The online version contains supplementary material available at 10.1007/s13555-023-01000-3.

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Section: Discussionmentioning

confidence: 99%

Comparative Efficacy of Targeted Systemic Therapies for Moderate-to-Severe Atopic Dermatitis without Topical Corticosteroids: An Updated Network Meta-analysis

Silverberg,

Hong,

Calimlim

et al. 2023

Dermatol Ther (Heidelb)

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“…33 There is growing evidence from clinical trials and real-world regarding short-and long-term-efficacy and safety of the recently approved biologics and JAKi in distinct populations 30, with network meta-analyses (NMA) and head-to-head studies even allowing (in)direct comparisons between treatments. [55][56][57][58][59][60][61]…”

Section: Update On Recently Approved B I Olog I C S and Jak Imentioning

confidence: 99%

“…The chronic‐relapsing course of AD requires a safe and long‐term management for patients of all ages 33 . There is growing evidence from clinical trials and real‐world regarding short‐ and long‐term‐efficacy and safety of the recently approved biologics and JAKi in distinct populations 30,33–55 with network meta‐analyses (NMA) and head‐to‐head studies even allowing (in)direct comparisons between treatments 55–61 …”

Section: Update On Recently Approved Biologics and Jakimentioning

confidence: 99%

Treatment of atopic dermatitis: Recently approved drugs and advanced clinical development programs

Müller,

Maintz,

Bieber

2024

Allergy

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Atopic dermatitis (AD) represents the most common skin disease characterized by heterogeneous endophenotypes and a high disease burden. In Europe, six new systemic therapies for AD have been approved: the biologics dupilumab (anti‐interleukin‐4 receptor (IL‐4R) α in 2017), tralokinumab (anti‐IL‐13 in 2021), lebrikizumab (anti‐IL‐13 in 2023), and the oral janus kinase (JAK) inhibitors (JAKi) targeting JAK1/2 (baricitinib in 2020 in the EU) or JAK1 (upadacitinib in 2021 and abrocitinib in 2022). Herein, we give an update on new approvals, long‐term safety, and efficacy. Upadacitinib and abrocitinib have the highest short‐term efficacy among the approved systemic therapies. In responders, dupilumab and tralokinumab catch up regarding long‐term efficacy and incremental clinical benefit within continuous use. Recently, the European Medicines Agency has released recommendations for the use of JAKi in patients at risk (cardiovascular and thromboembolic diseases, malignancies, (former) smoking, and age ≥65 years). Furthermore, we give an overview on emerging therapies currently in Phase III trials. Among the topical therapies, tapinarof (aryl hydrocarbon receptor), ruxolitinib (JAK1/2i), delgocitinib (pan‐JAKi), asivatrep (anti‐transient receptor potential vanilloid), and phosphodiesterase‐4‐inhibitors (roflumilast, difamilast) are discussed. Among systemic therapies, current data on cord‐blood‐derived mesenchymal stem cells, CM310 (anti IL‐4Rα), nemolizumab (anti‐IL‐31RA), anti‐OX40/OX40L‐antibodies, neurokinin‐receptor‐1‐antagonists, and difelikefalin (κ‐opioid‐R) are reported.

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“…Systemic therapy can be useful to reduce the total amount of topical corticosteroids in patients who need large amounts of potent topical corticosteroids for large body areas over prolonged periods to control their AD. Indeed, the area of systemic therapy for the treatment of AD has flourished in the past few years, as many new substances (including inhibitors of IL-4 and IL-13 signaling pathways as well as Janus kinase; JAK inhibitors) have been marketed, licensed, or are in the last stages of clinical development [3][4][5]. Development programs for these novel biologics are providing much better levels of evidence compared to older traditional drugs.…”

Section: Introductionmentioning

confidence: 99%

Burden of Disease in Real-Life Setting of Patients With Atopic Dermatitis: Italian Data From the MEASURE-AD Study

Argenziano,

Mercuri,

Savoia

et al. 2024

Dermatol Pract Concept

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Introduction: Atopic dermatitis (AD) is a chronic inflammatory skin disease that negatively impacts the quality of life and work productivity of patients. Objectives: We sought to evaluate the real-world burden of AD patients in Italy. Methods: This sub-analysis of the MEASURE-AD multicountry study conducted between December 2019-2020 included patients diagnosed with moderate-to-severe AD eligible for receiving systemic therapy in the previous 6 months. During a single visit, physician and patient-reported questionnaires were used. Results: A total of 118 adult patients were enrolled and 57.6% (N = 68) of patients had moderate-to-severe AD at the time of enrolment according to the Eczema Area and Severity Index.Sleep disorders interfered with daily function in the previous week in 58.5% (N = 69) of patients, pru-ritus was severe in 50% (N = 59) and 42.4% (N = 50) reported a flare lasting >7 days in the previous 6 months.According to the Dermatology Quality of Life Index, 37.3% (N = 44) of patients reported a severe impact of AD and approximately 10% had clinical depression/anxiety. Current drug therapy was considered inadequate in controlling AD in 26.3% (N=31) of patients.Work activity impairment was 38.6±31.7% and monthly AD-related expenses were 148.6±134.6 Euros per patient. Conclusions: This real-life study documents a high burden of disease in patients with moderate-severe AD in Italy.

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Comparing quality of life outcomes of JAK inhibitors and biological treatments for atopic dermatitis: a systematic review and network meta-analysis

Cited by 8 publications

References 35 publications

Comparative Efficacy of Targeted Systemic Therapies for Moderate-to-Severe Atopic Dermatitis without Topical Corticosteroids: An Updated Network Meta-analysis

Comparative Efficacy of Targeted Systemic Therapies for Moderate-to-Severe Atopic Dermatitis without Topical Corticosteroids: An Updated Network Meta-analysis

Treatment of atopic dermatitis: Recently approved drugs and advanced clinical development programs

Burden of Disease in Real-Life Setting of Patients With Atopic Dermatitis: Italian Data From the MEASURE-AD Study

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