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Olumiant ® (baricitinib)
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Olumiant® (baricitinib): Risk and comorbid COVID-19 in atopic dermatitis patients
Eli Lilly and Company has not studied the use of baricitinib in patients with atopic dermatitis and COVID-19 nor in atopic dermatitis patients at risk of contracting COVID-19.
Baricitinib and COVID-19
Baricitinib is not approved for the treatment of coronavirus disease 2019 (COVID-19), COVID-19 pneumonia, or COVID-19. Please see local labeling for approved indications.
COVID-19 risk in patients with atopic dermatitis treated with baricitinib
Efficacy and safety of baricitinib in patients with atopic dermatitis and COVID-19
An analysis of the efficacy and safety of baricitinib in patients with AD and COVID-19 has not been conducted.
Baricitinib infection-related warnings and precautions
COVID-19 is an active respiratory disease, which is typically mild and may also lead to acute respiratory distress syndrome or other medical complications that can be lethal. Please note the important BARI infection-related warnings and precautions listed below for consideration.
Baricitinib is associated with an increased rate of infections such as upper respiratory tract infections compared to placebo. In rheumatoid arthritis clinical studies, combination with methotrexate resulted in increased frequency of infections compared to baricitinib monotherapy.3
The risks and benefits of treatment with baricitinib should be carefully considered prior to initiating therapy in patients with active, chronic or recurrent infections.3
If an infection develops, the patient should be monitored carefully and baricitinib therapy should be temporarily interrupted if the patient is not responding to standard therapy. Baricitinib treatment should not be resumed until the infection resolves.3
Upper respiratory tract infections are very common (≥ 1/10) reported adverse drug reactions with BARI.
In atopic dermatitis clinical trials, the frequency of pneumonia was uncommon.3
Clinical use
The treating physician may use the information provided, the patient’s past medical history and concomitant medications, and other individual factors, in formulating an assessment and approach. The treating physician should consider potential risks and benefits of treatment options, and monitor appropriately.
Clinical management
Relevant reviews and guidelines on the management of atopic dermatitis during the COVID-19 pandemic are provided in the references below.4-6
Infectious disease resources
For the most current information regarding COVID-19, please refer to the WHO, ECDC and the EADV websites:
References
1Adaptive COVID-19 Treatment Trial 2 (ACTT-2). ClinicalTrials.gov identifier: NCT04401579. Updated August 13, 2020. Accessed August 24, 2020. https://clinicaltrials.gov/ct2/show/NCT04401579
2A study of baricitinib (LY3009104) in participants with COVID-19 (COV-BARRIER). ClinicalTrials.gov identifier: NCT04421027. Updated June 9, 2021. Accessed June 14, 2021. https://www.clinicaltrials.gov/ct2/show/NCT04421027
3Olumiant [summary of product characteristics]. Eli Lilly Nederland B.V., The Netherlands.
4Yim RM, Singh I, Armstrong AW. Updates on treatment guidelines for psoriasis, atopic dermatitis (eczema), hidradenitis suppurativa, and acne/rosacea during the COVID-19 pandemic. Dermatol Online J. 2020;26(10): https://escholarship.org/uc/item/0j5150df
5Ricardo JW, Lipner SR. Considerations for safety in the use of systemic medications for psoriasis and atopic dermatitis during the COVID-19 pandemic. Dermatol Ther. 2020;e13687. http://dx.doi.org/10.1111/dth.13687
6Torres T, Puig L. Managing cutaneous immune-mediated diseases during the COVID-19 pandemic. Am J Clin Dermatol. 2020;21(3):307-311. http://dx.doi.org/10.1007/s40257-020-00514-2
Date of Last Review: 11 November 2020
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