Draelos Zoe Diana, Stein Gold Linda F, Murrell Dedee F, Hughes Matilda H, Zane Lee T
J Drugs Dermatol. 2016 Feb;15(2):172-6.
Two post hoc analyses assessed the antipruritic activity of crisaborole topical ointment, 2% (crisaborole; Anacor Pharmaceuticals, Inc., Palo Alto, CA), a first-in-class boron-based phosphodiesterase-4 inhibitor in development for treatment of mild to moderate atopic dermatitis (AD).
Two pooled analyses included data from 4 studies evaluating crisaborole in AD (study 1, phase 1b, systemic exposure, safety, and pharmacokinetics [PK] under maximal-use conditions in children and adolescents; study 2, phase 2a, safety and PK in adolescents; study 3, phase 2a, efficacy and safety in adults; study 4, phase 2, efficacy and safety in adolescents). Pooled data from studies 1 and 2 included whole body assessments; studies 3 and 4 included target lesion assessments. Pruritus severity was evaluated using a 4-point rating scale (0=none to 3=severe). Efficacy assessments included percent change from baseline in pruritus severity scores at days 8 (first pooled assessment), 15, 22, and 29 (whole body assessments) or days 15 (first pooled assessment), 22, and 29 (target lesions). Paired t-tests comparing change from baseline against zero were used to calculate P values. Categorical shifts in pruritus severity were also assessed (no to mild pruritus, 0-1.5; moderate to severe pruritus, 2-3).
In the pooled analysis of studies 1 and 2 (N=57), the percent change from baseline in pruritus severity scores were 63.0% and 64.9% at days 8 and 29, respectively (P<0.001 for each). Similar results were observed in the pooled analysis of studies 3 and 4 (N=67). In both analyses, most patients had mild to no pruritus from the first time point assessed through the remainder of treatment.
Treatment with crisaborole topical ointment, 2% resulted in statistically significant reductions in pruritus severity at the first time point evaluated in both analyses. These findings provide preliminary evidence of the antipruritic activity of crisaborole topical ointment, 2%.
两项事后分析评估了2%克立硼罗外用软膏(克立硼罗;Anacor制药公司,加利福尼亚州帕洛阿尔托)的止痒活性,该药物是一种处于研发阶段的新型硼基磷酸二酯酶-4抑制剂,用于治疗轻至中度特应性皮炎(AD)。
两项汇总分析纳入了4项评估克立硼罗治疗AD的研究数据(研究1,1b期,在儿童和青少年最大使用条件下的全身暴露、安全性和药代动力学[PK];研究2,2a期,青少年的安全性和PK;研究3,2a期,成人的疗效和安全性;研究4,2期,青少年的疗效和安全性)。研究1和2的汇总数据包括全身评估;研究3和4包括目标皮损评估。使用4分制评分量表(0 = 无至3 = 严重)评估瘙痒严重程度。疗效评估包括在第8天(首次汇总评估)、15天、22天和29天(全身评估)或第15天(首次汇总评估)、22天和29天(目标皮损)时瘙痒严重程度评分相对于基线的变化百分比。使用配对t检验比较相对于基线的变化与零,以计算P值。还评估了瘙痒严重程度的分类变化(无至轻度瘙痒,0 - 1.5;中度至重度瘙痒,2 - 3)。
在研究1和2的汇总分析中(N = 57),瘙痒严重程度评分相对于基线的变化百分比在第8天和第29天分别为63.0%和64.9%(每次P < 0.001)。在研究3和4的汇总分析中(N = 67)观察到类似结果。在两项分析中,从首次评估时间点到治疗结束,大多数患者的瘙痒为轻度至无。
在两项分析中,首次评估时间点时,使用2%克立硼罗外用软膏治疗均使瘙痒严重程度在统计学上显著降低。这些发现为2%克立硼罗外用软膏的止痒活性提供了初步证据。