Adult atopic dermatitis (AD) patients often experience head and/or neck involvement which is bothersome and impacts the quality of life; however, long-term topical corticosteroids (TCS) are contraindicated for this difficult-to-treat region. Baricitinib, an oral, selective, reversible inhibitor of Janus kinase 1/2, has shown efficacy in adult patients with moderate to severe AD.

The present study used data from five Phase III trials to investigate the efficacy of baricitinib in patients with head and neck involvement.

It included studies that assessed the proportion of patients with improvement of Eczema Area and Severity Index (EASI) total score from baseline of ≥50% (EASI50) and ≥75% (EASI75), as well as head/neck EASI50 and EASI75 and erythema head/neck EASI50 and EASI75 response rates up to Week 16.

The study observed:

• 93-98% of patients showed head/neck involvement at baseline (EASI head/neck score ≥1).
• Baricitinib showed similar effectiveness for the entire body, based on EASI total score, in all studies.
• Baricitinib 2-mg and 4-mg showed a significantly higher proportion of patients to achieve head/neck EASI50 and EASI75 scores versus placebo at Weeks 1 and 16.

This study shows that baricitinib 2-mg and 4-mg treatment rapidly and substantially reduces AD head and neck severity, including erythema.

Source: Wollenberg A, Lio P, Kleyn E, Bissonnette R, Jose Rueda M, Casillas M, et al. Improvement of head and neck symptoms in patients with atopic dermatitis treated with baricitinib based on five Phase III clinical trials. Eur J Dermatol. 2022;32(4):522-9. English.