Find out more about the trial and how to refer patients.

The BEACON trial is an important and very timely opportunity to obtain comparative data on the key systemic therapies used to treat moderate to severe adult eczema.

It will provide the first ever comprehensive evidence on the comparative effectiveness, tolerability and cost-effectiveness of oral ciclosporin, subcutaneous methotrexate, and subcutaneous dupilumab.

These represent three key classes of therapy, with ciclosporin being the only licensed ‘standard’ agent, methotrexate the most commonly prescribed standard agent and dupilumab as a novel biologic therapy. BEACON will also inform the optimal treatment pathway over 12 months. These data will translate into improved health outcomes, minimise treatment switching, and enable healthcare commissioning based on clinical evidence and value for money.

BEACON will serve as a future platform for comparisons across the large pipeline of emerging novel therapies as it will permit the inclusion of additional treatment arms in a future multi-arm multi-stage platform trial. This, to our knowledge, represents the first platform trial for inflammatory skin disease. The first planned additional arm is a Janus Kinase Inhibitor, abrocitinib, in collaboration with Pfizer.

A platform design offers a highly efficient way of comparing novel agents with best available treatment (statistical, operational and cost efficiency) whilst accommodating changes to the standard of care over time. An aligned bioresource for biomarker discovery will inform future personalised therapy and will capitalise on existing bio-resourcing infrastructure.

To inform implementation of the findings a process evaluation will run within the trial exploring patients’ expectations of treatment, experiences in the trial, experiences of treatment(s) and the process of switching treatments.

At hospital sites that are also taking part in the UK-Irish Atopic Eczema Systemic Therapy Register (A-STAR), BEACON participants will be invited to enroll in it for long-term follow up. A-STAR is an observational study running in the UK and Ireland, collecting data on the short and long-term safety and effectiveness of systemic treatments for people with atopic eczema funded by the British Skin Foundation and the British Association of Dermatologists.