“Olumiant provides rapid AD symptom improvement"

[Interview] Professor Sang Wook Son (Department of Dermatology, Korea University Ansan Hospital)

Provides new treatment option to moderate-to-severe atopic dermatitis patients

Strength is in providing rapid improvement from Day 2… differentiated as an oral formulation

The introduction of JAK inhibitors in the field of moderate-to-severe atopic dermatitis (AD) treatment was like a welcome rain in the drought of treatment options in AD.

 

In 2018, the approval of the biologic agent ‘Dupixent’ transformed the AD treatment paradigm, however, many patients still feel an unmet need existed due to the limited reimbursement conditions and high drug price.

 

JAK inhibitors are expected to widen the scope of treatment options for AD patients with features different than those offered by Dupixent.

 

The first JAK inhibitor to receive approval for the AD indication was Eli Lilly’s ‘Olumiant (baricitinib)’ The treatment effect and safety of Olumiant were identified in the three clinical trials - BREEZE-AD1, BREEZE-AD2, BREEZE-AD7 –as a monotherapy and combination therapy with a topical corticosteroid (TCS) in adult patients with moderate to severe AD.

 

In particular, Olumiant rapidly improved itching that severely deteriorates the quality of life from Day 2.

 

Professor Sang Wook Son (Department of Dermatology, Korea University Ansan Hospital), who has been prescribing Olumiant from the clinical stages said, “Olumiant will play an important role in improving the symptoms and quality of life of patients.

 

The various new drugs that have been introduced to the AD treatment environment have brought a ‘revolution’ to the AD treatment environment.” Dailypharm met with Professor Son to hear about the adult atopic dermatitis treatment environment and the role of Olumiant in Korea.

 

Professor Sang Wook Son

-Clinical trials on Olumiant have shown that it rapidly improves symptoms from the second day since its first administration.

 

What does this mean for moderate to severe AD patients?” = For AD patients, managing pruritus, or itching, is very important.

 

However, this symptom was difficult to control, as the inflammatory response or immune response, which are mechanical aspects that cause itching, are difficult to control.

 

We use immunosuppressants and antihistamines for pruritus treatment, but it was difficult to expect dramatic effects with these treatments.

 

This lack of a rapid and effective treatment option for severe itching had made treating AD patients quite difficult, and Olumiant’s data on its rapid effect was the most awaited aspect of the new drug.

 

I have been experiencing this rapid symptom improvement effect of Olumiant in clinical practice, and believe this feature will continue to be one of the greatest strengths of Olumiant.

 

- Olumiant’s oral formulation is also considered beneficial.

 

For which patients would the oral Olumiant tablet be appropriate? =According to Olumiant’s indication, patients with moderate to severe AD, in other words, those whose Eczema Area and Severity Index (EASI) score is between 16-23 or over may use Olumiant.

 

However, as there is only little experience accumulated in the actual clinical field with Olumiant, there is still no consensus or guideline on which treatment should be used for which patient.

 

However, Olumiant has the benefit of being easy to carry as an oral formulation.

 

Patients may conveniently carry around and take Olumiant from their bag according to their dosing schedule.

 

Also, they can flexibly apply doses, reducing the dose or taking a resting period when symptoms improve.

 

Also, patients who fear needles would also prefer oral forms of treatment.

 

-AD is a chronic disease that requires long-term use of treatments.

 

Therefore, the safety of long-term administration is also an important aspect in selecting treatments.

 

I heard there were safety concerns in using JAK inhibitors.

 

How about Olumiant?

 

=Olumiant has around 7 years’ worth of long-term safety data accumulated in the field of rheumatoid arthritis.

 

No special adverse events were identified as an issue during that period.

 

Based on these results, there are expectations that Olumiant will have fewer side effects than existing treatment options not only in clinical studies but also in actual clinical settings -Olumiant can be administered alone or in combination with a topical corticosteroid (TCS) =Combination therapies are considered a sort of principle in AD treatment as it requires the use of TCS and other topical immunomodulators to achieve full effect.

 

In particular, data has shown that the efficacy of treatment improves when using Olumiant with TCS in AD.

 

-What role do you expect Olumiant will play in the treatment of adult AD? = I felt more confident treating patients after Olumiant was added as an AD treatment option.

 

Compared to existing treatments, Olumiant has little burden of safety has a positive therapeutic effect.

 

As patients can experience dramatic changes in various aspects including treatment satisfaction, improvement of quality of life, and improvement of itching and lesions, I have high expectations for Olumiant's role in the field of AD treatment.