BEACON: Best systemic treatments for adults with atopic eczema over the long term
Research type
Research Study
Full title
A phase IV, assessor-blind randomised control trial comparing the effectiveness, tolerability and cost effectiveness of ciclosporin, methotrexate, and dupilumab in adults with moderate-severe eczema.
IRAS ID
1004703
Contact name
Andrew Pink
Contact email
Sponsor organisation
Guy's and St Thomas' NHS Foundation Trust
Research summary
Eczema is a skin disease affecting 1 in 20 UK adults. People with eczema itch constantly and the damaged inflamed skin often gets infected, leading to disfigurement, low mood and a negative impact on quality of life.
More severe eczema requires ‘systemic’ treatments such as methotrexate and ciclosporin that dampen down the immune system. Recently, treatments have been developed to block signals from a type of immune cell particularly important in eczema. Dupilumab is the first of these treatments available on the NHS but so far studies have only compared dupilumab with placebo.
The aim of this trial is to compare the effectiveness, tolerability, and cost of dupilumab and methotrexate to ciclosporin.
Adults with moderate to severe eczema will get either oral ciclosporin, methotrexate self-injection or dupilumab self-injection for up to one year. Patients will know which treatment they are on but the person assessing the eczema will not know to make sure we come up with a truthful answer.
Participants will complete questionnaires between visits about any side-effects and whether they have used any other NHS services. There will be an option to increase the treatment dose after 3 months and at 6 months the treatment can be changed if it is not working sufficiently. We will judge the success of the different treatments by looking at participants’ skin using a reliable eczema score and by asking participants about things like itching and quality of life. We will collect information about side effects and whether the treatments are cost-effective.
We have worked with eczema patients and the National Eczema Society (NES) in designing this study and will continue to work with them throughout the trial. We will ensure we tell everyone about our results by working with our patient community, NES and various professional networks that we belong to.REC name
London - Harrow Research Ethics Committee
REC reference
23/LO/0224
Date of REC Opinion
29 Sep 2023
REC opinion
Further Information Favourable Opinion