Aryl-Hydrocarbon-Rezeptor als Zielstruktur für neue Medikamente bei Psoriasis und atopischer Dermatitis

[Development of new topical substances for the treatment of atopic dermatitis]

Atopic dermatitis (AD) is one of the most common chronic inflammatory skin diseases. In everyday clinical practice, about 80% of patients present with mild to moderate disease, which is usually treated with topical therapy. Topical anti-inflammatory therapy thus continues to be the standard of care in addition to the basic therapy. Topical glucocorticoids (TGC) and topical calcineurin inhibitors (TCI) are two potent approved substances that are available. In addition to newly developed systemic therapies for moderate to severe AD, there are also new therapeutic approaches in anti-inflammatory topical treatment. Topical Janus kinase inhibitors show a high therapeutic effect. However, only delgocitinib and ruxolitinib have so far been approved for topical administration in Japan and the USA since 2021. Crisaborole, a phosphodiesterase 4 inhibitor, also received approval in the USA. Other phosphodiesterase inhibitors are currently being investigated in clinical trials. Interesting results of clinical studies give hope for further substances and therapeutic approaches.

A double-blind, randomized, placebo- and positive-controlled phase III trial of 1% benvitimod cream in mild-to-moderate plaque psoriasis

Background

Benvitimod cream, a novel synthetic small molecule, was effective in treating mild-to-moderate plaque psoriasis. We conducted a phase III clinical trial to assess the efficacy and safety of benvitimod cream in patients with mild-to-moderate plaque psoriasis.

Methods

We randomly assigned 686 patients (2:1:1) to receive 1% benvitimod cream, 0.005% calcipotriol ointment or placebo twice a day for 12 weeks. The primary efficacy end points were the percentage of patients with a 75% or greater reduction from baseline in the psoriasis area and severity index (PASI 75) score and with a score of 0 or 1 in static physician's global assessment (sPGA) at week 12.

Results

The results showed that 50.4% of patients in the benvitimod group achieved PASI 75, which was significantly higher than that in the calcipotriol (38.5%, P < 0.05) and placebo (13.9%, P < 0.05) groups. The proportion of patients achieving an sPGA score 0 or 1 was 66.3% in the benvitimod group and 63.9% in the calcipotriol group, which were both significantly higher than that in the placebo group (34%, P < 0.05). In the long-term follow-up study, 50.8% of patients experienced recurrence. After retreatment with 1% benvitimod, 73.3% of patients achieved an sPGA score of 0 or 1 again at week 52. Adverse events included application site irritation, follicular papules, and contact dermatitis. No systemic adverse reactions were reported.

Conclusion

During this 12-week study, benvitimod cream was demonstrated with high effectiveness and safety in patients with mild-to-moderate plaque psoriasis.

Trial Registration

Chinese Clinical Trial Registry (ChiCTR), ChiCTR-TRC-13003259; http://www.chictr.org.cn/showprojen.aspx?proj=6300.