Evaluating the safety and efficacy of baricitinib for the treatment of moderate-to-severe atopic dermatitis

ABSTRACT

Introduction

New biologic and small molecule therapeutics have emerged for the treatment of moderate-to-severe atopic dermatitis (AD), including oral Janus kinase (JAK) inhibitors such as baricitinib. While JAK inhibitors are commonly used to treat rheumatoid arthritis and inflammatory bowel disease, these agents are relatively new in the field of dermatology.

Areas covered

In this review, we outline the efficacy and safety data of phase III randomized controlled trials investigating the use of baricitinib for moderate-to-severe AD. A literature search was performed using PubMed.gov to identify articles relevant to the topic published before August 2023.

Expert opinion

Oral JAK inhibitors in AD management are highly efficacious, whether used alone, in conjunction with topical corticosteroids, or in patients who have failed other conventional systemic medications for AD. JAK inhibitors appear to be well tolerated in the AD patient population with fewer major safety risks than what has been seen in other patient populations. Assessing patient risk factors for cardiovascular, thromboembolic, and oncologic diseases is now an important part of the office visit for patients in whom you may consider using a JAK inhibitor.

KEYWORDS:

• Baricitinib
• atopic dermatitis
• BREEZE-AD
• safety
• efficacy

Article highlights

• Atopic dermatitis is a chronic debilitating disease that is currently experiencing a revolution in disease management thanks to the development of targeted, disease-specific therapeutic agents.

• Baricitinib, an oral inhibitor of both JAK1 and JAK2, is currently under investigation for treatment of atopic dermatitis.

• The data from seven phase III RCTs indicate that baricitinib is effective in improving moderate-to-severe atopic dermatitis in both adult and pediatric patients.

• Baricitinib appears to be well tolerated in the AD patient population with fewer major safety risks than what has been seen in other patient populations.

• As JAK inhibitors become more widely used in AD, we will continue to learn more about their utility in management of this condition.

Declaration of interest

L Strowd has received research funding, grants, or honoraria from: Sanofi, Regeneron, Pfizer, Galderma, Lilly, Novartis, and Arcutis.

The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer disclosures

A reviewer on this manuscript has disclosed that they are a consultant, speaker, and investigator for Lilly laboratories. Peer reviewers on this manuscript have no other relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.