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The Capital Region of Denmark - a part of Copenhagen University Hospital
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Pooled safety analysis of baricitinib in adult patients with atopic dermatitis from 8 randomized clinical trials

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  • 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
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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.

Original languageEnglish
JournalJournal of the European Academy of Dermatology and Venereology : JEADV
Volume35
Issue number2
Pages (from-to)476-485
Number of pages10
ISSN0926-9959
DOIs
Publication statusPublished - Feb 2021

    Research areas

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

ID: 67626209