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Improvements in itch and sleep following treatment with baricitinib in combination with topical corticosteroids are associated with better quality of life and productivity in adult patients with moderate-to-severe atopic dermatitis: a post hoc analysis from BREEZE-AD7 Volume 32, issue 2, March-April 2022

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Authors
1 Department of Dermatology, Kyoto Prefectural University of Medicine Graduate School of Medical Science, Kyoto, Japan
2 Eli Lilly and Company, Indianapolis, Indiana, USA
3 St John’s Institute of Dermatology, Guy’s and St Thomas’ NHS Foundation Trust, London, United Kingdom
4 Dermatology Section, Department of Medicine and Surgery, University of Perugia, Perugia, Italy
5 Institute and Comprehensive Center for Inflammation Medicine, University of Luebeck, University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany
Reprints: Andrew Buchanan

Background

Treatment with baricitinib in combination with topical corticosteroids previously showed greater improvements in itch and sleep versus placebo in adults with moderate-to-severe AD.

Objectives

To assess whether improvements in itch and sleep translate to greater quality of life (QoL), productivity and treatment benefit in AD.

Materials & Methods

In this post hoc analysis with data from BREEZE-AD7 (NCT03733301), itch and sleep improvements at Week 16 were defined by ≥4-point improvements in the Itch Numeric Rating Scale and ≥1.5 decreases in the number of night-time awakenings since baseline, respectively. Dermatology Life Quality Index, Work Productivity and Activity Impairment-AD and Patient Benefit Index (PBI) scores were compared in patients with and without improvements. Proportions were analysed using logistic regression with non-responder imputation. Changes from baseline were calculated using ANCOVA, with last observation carried forward. Least square mean PBI scores were assessed using ANOVA.

Results

More patients with itch improvement versus no itch improvement reported no impact of AD on QoL (28.4% vs. 6.0%). Daily activity impairment was lower in patients with itch improvement (-39.6% vs. -15.6%). A greater proportion of patients with sleep improvement versus no sleep improvement had no AD-related impact on QoL (24.1% vs. 1.5%). Patients with sleep improvement had less daily activity impairment (-35.0% vs. -18.5%). Patients with itch and sleep improvements experienced greater treatment benefit.

Conclusion

Patients with AD who experienced clinically meaningful improvements in itch and sleep following treatment had significantly better QoL, productivity and treatment benefit. Addressing these symptoms is important to achieving meaningful and patient-relevant improvements in well-being.