Real-world meta-analysis of baricitinib for atopic dermatitis shows variable outcomes
Photo by National Cancer Institute / Unsplash
Key Takeaway
Consider that baricitinib improves eczema in real-world settings, but itch response varies widely across patients.
This is a real-world meta-analysis pooling data from three European national atopic dermatitis registries (BioDay, SCRATCH, TREATgermany) to evaluate baricitinib effectiveness in 264 patients with moderate-severe atopic dermatitis over 16 weeks. The primary outcomes were Eczema Area and Severity Index (EASI) and itch Numerical Rating Scale (Itch-NRS).
At week 13/16, the proportion of patients achieving EASI≤7 ranged from 58% in BioDay to 68% in SCRATCH and 62% in TREATgermany, with a pooled estimate of 62% (95% CI: 50-73%). The pooled mean EASI change was -7.8 (95% CI: -14.4 to -1.1). For itch, the proportion achieving Itch-NRS≤4 varied substantially across registries, from 20% (BioDay) to 71% (TREATgermany).
The authors note notable heterogeneity, particularly for the Itch-NRS outcome, which limits the precision of pooled estimates. Safety data were not reported, so no conclusions about adverse events can be drawn. As an observational real-world analysis, causality cannot be inferred.
These findings support the effectiveness of baricitinib in real-world settings but highlight variability in patient outcomes, especially for itch. Clinicians should consider individual patient factors when interpreting these results.
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View Original Abstract ↓
Clinical trials have demonstrated the effectiveness of baricitinib, an oral selective Janus kinase 1/2 inhibitor, for patients with moderate-severe atopic dermatitis, but data from real-world practice are limited. This non-interventional cohort study evaluated clinician- and patient-reported disease severity over 16 weeks using 3 national atopic dermatitis registries: BioDay (Netherlands), SCRATCH (Denmark) and TREATgermany (Germany). Absolute scores for Eczema Area and Severity Index (EASI) and itch Numerical Rating Scale (Itch-NRS) were assessed at baseline and follow-up (Week 13/16) for each registry and for the overall pooled cohort. Descriptive analyses, generalized linear mixed modelling and meta-analysis approaches were applied to complete-case and multiply-imputed datasets. In total, 264 patients (89 BioDay, 117 SCRATCH, 58 TREATgermany) were included. Results showed improvements in EASI, with 58%, 68% and 62% achieving EASI≤7 at Week 13/16 in BioDay, SCRATCH and TREATgermany, respectively. In the pooled cohort, the proportion was 62% (95% CI: 50-73%). The pooled mean EASI change was -7.8 [14.4,-1.1]. Effectiveness was generally observed in both biologic-naïve and -experienced patients. Notable heterogeneity was observed, particularly for Itch-NRS, with the proportion achieving NRS≤4 ranging from 20% (BioDay) to 71% (TREATgermany). These real-world findings support the effectiveness of baricitinib while also highlighting variability in patient outcomes.
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