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

Abstract

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:

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:

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:

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:

This integrated safety analysis in patients with moderate-to-severe AD confirms the established safety profile of baricitinib.

• Authors: T Bieber, J P Thyssen, K Reich, E L Simpson, N Katoh, A Torrelo, M De Bruin-Weller, D Thaci, R Bissonnette, M Gooderham, J Weisman, F Nunes, D Brinker, M Issa, K Holzwarth, M Gamalo, E Riedl, J Janes
• Journal: Journal of the European Academy of Dermatology and Venereology : JEADV (J Eur Acad Dermatol Venereol) Vol. 35 Issue 2 Pg. 476-485 (Feb 2021) ISSN: 1468-3083 [Electronic] England
• PMID: 32926462 (Publication Type: Journal Article)
• 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.

Chemical References

• Azetidines
• Pharmaceutical Preparations
• Purines
• Pyrazoles
• Sulfonamides
• baricitinib

Topics

• Adult
• Azetidines
• Dermatitis, Atopic (drug therapy)
• Double-Blind Method
• Humans
• Pharmaceutical Preparations
• Purines
• Pyrazoles
• Randomized Controlled Trials as Topic
• Sulfonamides
• Treatment Outcome