The BEACON trial will provide the first ever comprehensive evidence on the comparative effectiveness, tolerability and cost-effectiveness of ciclosporin, subcutaneous methotrexate, dupilumab and a janus kinase inhibitor (exemplar to be confirmed) to treat moderate to severe adult eczema.
Mild eczema can usually be treated with creams and ointments but more severe eczema needs ‘systemic’ treatments taken by mouth or injection. The four key therapeutic classes used to treat this disease in the UK are represented in this trial and the findings will serve as a future platform for comparisons across emerging novel therapies. This will help clinicians to identify the best treatments for patients with moderate to severe eczema.
BEACON is a UK-wide randomised, controlled, 12-month assessor-blind trial in 536 adults who require systemic treatment for their eczema. The primary outcome is an objective measure – clinician-assessed signs of eczema at six months (blinded assessment) using Eczema Area and Severity Index (EASI). Secondary outcomes include patient reported symptoms (POEM), itch intensity, disease control, depression and anxiety, safety and tolerability, quality of life and cost effectiveness. These outcomes include the HOME core outcome set for atopic eczema.
The trial will use a platform design to enable new biologic and oral therapies for eczema to be included in the trial as additional comparator arms in the future.
We are working with eczema patients and the National Eczema Society (NES). We will share our results by working with our patient community, NES and multiple professional networks.
The BEACON trial is led by Professor Catherine Smith (Programme Lead) and Dr Andrew Pink (Chief Investigator), consultant dermatologists at St. John’s Institute of Dermatology, Guy’s and St Thomas’ NHS Foundation Trust. Professor Smith is a national lead for eczema and psoriasis services and Dr Pink is the Director of the Adult Clinical Trials Unit at St. John’s Institute of Dermatology.