Department of Dermatology, University Hospital Münster, Munster, Germany.
Department of Dermatology, UTHealth McGovern Medical School-Houston, 6655 Travis Street, Suite 980, Houston, TX, 77030, USA.
Paediatr Drugs. 2022 Mar;24(2):175-183. doi: 10.1007/s40272-021-00490-y. Epub 2022 Mar 16.
This post hoc analysis of pooled data from two phase III studies (AD-301: NCT02118766; AD-302: NCT02118792) explored the efficacy and safety of crisaborole ointment, 2%, a nonsteroidal phosphodiesterase 4 inhibitor, for the treatment of mild-to-moderate atopic dermatitis (AD) in pediatric patients (aged 2 to < 18 years) only, stratified by baseline characteristics.
Pediatric patients with mild or moderate AD per Investigator's Static Global Assessment (ISGA) and percentage of treatable body surface area (%BSA) ≥ 5 at baseline were assessed. Crisaborole or vehicle (2:1 randomization ratio) was applied twice daily for 28 days. Of the 1313 pediatric patients included in this study, 874 received crisaborole and 439 received vehicle. ISGA success was defined as clear (0) or almost clear (1) with ≥ 2-grade improvement from baseline. Efficacy and safety were stratified by age group, sex, baseline ISGA, baseline %BSA per published severity strata, and prior AD therapy.
Overall, the proportions of crisaborole-treated and vehicle-treated pediatric patients with ISGA success at week 4 were 32.5 and 21.5%, respectively. ISGA success rates at day 29 (week 4) were generally higher in crisaborole-treated (21.9-38.1%) than vehicle-treated (15.7-26.9%) patients across subgroups. Rates of treatment-related application site pain were 2.4-10.1% for crisaborole-treated patients and 0.6-2.2% for vehicle-treated patients across subgroups. No new safety concerns were noted in any patient subgroup.
Crisaborole improved global disease severity and was reasonably well tolerated across all pediatric baseline characteristic subgroups. Application site discomfort was greater with crisaborole than with vehicle, but few patients discontinued treatment.
NCT02118766; NCT02118792 (registration date: April 21, 2014).
本事后分析汇总了两项 3 期研究(AD-301:NCT02118766;AD-302:NCT02118792)的数据,旨在探讨非甾体磷酸二酯酶 4 抑制剂 2%匹美莫司软膏治疗儿童轻中度特应性皮炎(AD)的疗效和安全性,纳入患者均为 2 岁至<18 岁,按基线特征分层。
根据研究者静态整体评估(ISGA)和基线时可治疗体表面积(%BSA)≥5%,评估患有轻度或中度 AD 的儿科患者。患者接受匹美莫司或赋形剂(2:1 随机分配),每日 2 次,持续 28 天。在这项研究的 1313 例儿科患者中,874 例接受匹美莫司治疗,439 例接受赋形剂治疗。ISGA 疗效评估标准为:与基线相比,疗效指数(IGA)改善≥2 级,为完全清除(0 分)或几乎完全清除(1 分)。根据年龄组、性别、基线 ISGA、基于发表的严重程度分层的基线%BSA 和既往 AD 治疗,对疗效和安全性进行分层。
总体而言,第 4 周时,接受匹美莫司治疗和接受赋形剂治疗的儿科患者中,ISGA 疗效达标的比例分别为 32.5%和 21.5%。在各亚组中,匹美莫司治疗组(21.9%-38.1%)在第 29 天(第 4 周)时的 ISGA 疗效达标率均高于赋形剂治疗组(15.7%-26.9%)。在各亚组中,匹美莫司治疗组患者治疗相关的用药部位疼痛发生率为 2.4%-10.1%,赋形剂治疗组为 0.6%-2.2%。各患者亚组均未出现新的安全性问题。
匹美莫司软膏可改善儿童患者的整体疾病严重程度,在所有儿科患者基线特征亚组中均具有较好的耐受性。与赋形剂相比,匹美莫司软膏引起的用药部位不适更常见,但很少有患者因该不良反应而停药。
NCT02118766;NCT02118792(登记日期:2014 年 4 月 21 日)。