A. Gemelli IRCCS, UOC Di Dermatologia, Fondazione Policlinico Universitario , Rome, Italy.
Dermatologia, Università Cattolica Del Sacro Cuore , Rome, Italy.
Expert Opin Investig Drugs. 2020 Oct;29(10):1089-1098. doi: 10.1080/13543784.2020.1800639. Epub 2020 Aug 14.
Atopic dermatitis (AD) is a chronic inflammatory skin disease mediated by multiple signals including janus kinase (JAK)/signal transducer and activator of transcription (STAT) pathway. Current therapeutic armamentarium consists of a limited number of drugs which may result in the insufficient management of AD. Preclinical evidence regarding inhibition of JAK/STAT led to the development of a promising class of therapeutics, namely, JAK inhibitors. Baricitinib, a novel JAK1/JAK2 inhibitor is currently under investigation in AD clinical trials.
This review offers an overview of Baricitinib and examines clinical efficacy and safety data in patients with moderate-to-severe AD.
Baricitinib showed promising preliminary data in terms of efficacy in phase II and III trials, with a very rapid onset of response and great improvements of itch and sleep disturbances. These aforementioned aspects combined with the advantage of an oral formulation have reduced drug production costs compared to biologic agents and could lead to consideration of baricitinib as a first line systemic treatment. Also, in some countries, it could be a therapeutic option in the case of contraindication or failure of conventional systemic drugs prior to biologic therapies. Data related to long-term safety and efficacy will be important to refine the place-in-therapy of this drug.
特应性皮炎(AD)是一种由多种信号介导的慢性炎症性皮肤病,包括 Janus 激酶(JAK)/信号转导和转录激活因子(STAT)通路。目前的治疗手段包括数量有限的药物,这可能导致 AD 管理不足。关于 JAK/STAT 抑制的临床前证据导致了一类有前途的治疗药物的发展,即 JAK 抑制剂。巴利昔替尼是一种新型的 JAK1/JAK2 抑制剂,目前正在 AD 临床试验中进行研究。
本综述概述了巴利昔替尼,并检查了中度至重度 AD 患者的临床疗效和安全性数据。
巴利昔替尼在 II 期和 III 期试验中的疗效显示出有希望的初步数据,具有非常快速的起效和显著改善瘙痒和睡眠障碍。这些方面与口服制剂的优势相结合,与生物制剂相比降低了药物生产成本,可能使巴利昔替尼被考虑作为一线全身治疗药物。此外,在一些国家,在生物治疗之前,如果常规全身药物有禁忌或失败,它可能是一种治疗选择。与长期安全性和疗效相关的数据对于细化这种药物的治疗地位非常重要。