Hoy Sheridan M
Springer Nature, Private Bag 65901, Mairangi Bay, Auckland, 0754, New Zealand.
Am J Clin Dermatol. 2022 May;23(3):409-420. doi: 10.1007/s40257-022-00684-1. Epub 2022 May 3.
Baricitinib (Olumiant) is an oral small molecule inhibitor of Janus kinase (JAK)1 and JAK2, which have been implicated in the pathogenesis of atopic dermatitis (AD). In phase III studies in adults with moderate to severe AD who were inadequately controlled with topical corticosteroids (TCS) or systemic treatments (e.g. ciclosporin), or for whom these therapies were not advisable, baricitinib, alone or in combination with TCS, achieved significant and/or clinically relevant improvements in multiple measures of disease severity, pruritus, skin pain, sleep disturbance and health-related quality of life (HR-QOL) over 16 weeks. Benefit onset was rapid, with efficacy generally sustained over the longer term (treatment duration ≤ 68 weeks). In this patient population, the safety profile of baricitinib was consistent with that established in the moderate to severe rheumatoid arthritis (RA) population. Although further longer-term data would be beneficial, current evidence indicates that baricitinib, alone or in combination with TCS, provides an oral alternative to subcutaneous biologics for the treatment of moderate to severe AD in adults who are candidates for systemic therapy.
巴瑞替尼（Olumiant）是一种口服小分子Janus激酶（JAK）1和JAK2抑制剂，JAK1和JAK2与特应性皮炎（AD）的发病机制有关。在针对中度至重度AD成人患者的III期研究中，这些患者使用外用糖皮质激素（TCS）或全身治疗（如环孢素）控制不佳，或不适合使用这些疗法，巴瑞替尼单独使用或与TCS联合使用，在16周内使疾病严重程度、瘙痒、皮肤疼痛、睡眠障碍和健康相关生活质量（HR-QOL）的多项指标取得了显著和/或临床相关的改善。疗效起效迅速，长期（治疗持续时间≤68周）疗效通常得以维持。在该患者群体中，巴瑞替尼的安全性与中度至重度类风湿性关节炎（RA）群体中确立的安全性一致。尽管进一步的长期数据会有所助益，但目前的证据表明，对于适合进行全身治疗的成人中度至重度AD患者，巴瑞替尼单独使用或与TCS联合使用可提供一种替代皮下生物制剂的口服治疗方案。
