Howard University College of Medicine, Washington, DC, USA.
Callender Dermatology and Cosmetic Center, Glenn Dale, MD, USA.
Am J Clin Dermatol. 2019 Oct;20(5):711-723. doi: 10.1007/s40257-019-00450-w.
Atopic dermatitis is highly prevalent in black/African American, Asian, and Hispanic patients, making assessment of these populations in clinical trials important. Crisaborole ointment, 2%, is a nonsteroidal phosphodiesterase 4 inhibitor for the treatment of mild-to-moderate atopic dermatitis. In two pivotal phase III clinical trials in patients aged ≥ 2 years, crisaborole was superior to vehicle in reducing global disease severity. The most common treatment-related adverse event was application site pain.
The objective of this study was to investigate the efficacy and safety of crisaborole according to patient race and ethnicity.
A pooled post hoc analysis by race and ethnicity of the two pivotal trials and a safety extension trial was performed. Race included white or nonwhite (encompassing Asian/native Hawaiian/other Pacific Islander, black/African American, and other/American Indian/Alaskan native); ethnicity included Hispanic/Latino or not Hispanic/Latino.
In white, nonwhite, Hispanic/Latino, and not Hispanic/Latino groups at day 29, more crisaborole- than vehicle-treated patients achieved improvements in global disease severity [Investigator's Static Global Assessment of clear/almost clear with a ≥ 2-grade improvement (white: 33.5% vs. 22.3%, nominal p < 0.001; nonwhite: 30.0% vs. 21.3%, nominal p < 0.05; Hispanic/Latino: 35.4% vs. 18.2%, nominal p < 0.01; not Hispanic/Latino: 31.3% vs. 22.8%, nominal p < 0.01)]. Crisaborole treatment also improved atopic dermatitis signs/symptoms and quality of life. Frequency of crisaborole-related adverse events was 7.1-8.5% in the pivotal trials.
Across races and ethnicities, crisaborole demonstrated efficacy for the treatment of mild-to-moderate atopic dermatitis, with a low frequency of treatment-related adverse events.
特应性皮炎在黑种人/非裔美国人、亚洲人和西班牙裔人群中高度流行,因此在临床试验中评估这些人群非常重要。2%的克立硼罗软膏是一种非甾体磷酸二酯酶 4 抑制剂,用于治疗轻度至中度特应性皮炎。在两项针对年龄≥2 岁的患者的关键性 3 期临床试验中,克立硼罗优于赋形剂,可降低整体疾病严重程度。最常见的治疗相关不良事件是用药部位疼痛。
本研究旨在根据患者的种族和民族研究克立硼罗的疗效和安全性。
对两项关键性试验和一项安全性扩展试验按种族和民族进行了汇总事后分析。种族包括白种人或非白种人(包括亚裔/夏威夷原住民/其他太平洋岛民、黑种人/非裔美国人以及其他/美洲印第安人/阿拉斯加原住民);民族包括西班牙裔/拉丁裔或非西班牙裔/拉丁裔。
在第 29 天,与接受赋形剂治疗的患者相比,更多接受克立硼罗治疗的白种人、非白种人、西班牙裔/拉丁裔和非西班牙裔/拉丁裔患者在整体疾病严重程度方面得到改善[研究者静态全球评估(IGA)为清除/几乎清除且改善≥2 级(白种人:33.5%比 22.3%,名义 p<0.001;非白种人:30.0%比 21.3%,名义 p<0.05;西班牙裔/拉丁裔:35.4%比 18.2%,名义 p<0.01;非西班牙裔/拉丁裔:31.3%比 22.8%,名义 p<0.01)]。克立硼罗治疗还改善了特应性皮炎的体征/症状和生活质量。在关键性试验中,与克立硼罗相关的不良事件发生率为 7.1%~8.5%。
在不同种族和民族中,克立硼罗治疗轻度至中度特应性皮炎的疗效确切,治疗相关不良事件的发生率较低。