Dupilumab therapy of atopic dermatitis of the elderly: a multicentre, real-life study

被引：78

作者：

Patruno, C. ^{[1
]}

Napolitano, M. ^{[2
]}

Argenziano, G. ^{[3
]}

Peris, K. ^{[4
,5
]}

Ortoncelli, M. ^{[6
]}

Girolomoni, G. ^{[7
]}

Offidani, A. ^{[8
]}

Ferrucci, S. M. ^{[9
]}

Amoruso, G. F. ^{[10
]}

Rossi, M. ^{[11
]}

Stingeni, L. ^{[12
]}

Malara, G. ^{[13
]}

Grieco, T. ^{[14
]}

Foti, C. ^{[15
]}

Gattoni, M. ^{[16
]}

Loi, C. ^{[17
]}

Iannone, M. ^{[18
]}

Talamonti, M. ^{[19
]}

Stinco, G. ^{[20
]}

Rongioletti, F. ^{[21
]}

Pigatto, P. D. ^{[22
]}

Cristaudo, A. ^{[23
]}

Nettis, E. ^{[24
]}

Corazza, M. ^{[25
]}

Guarneri, F. ^{[26
]}

Amerio, P. ^{[27
]}

Esposito, M. ^{[28
]}

Belloni Fortina, A. ^{[29
]}

Potenza, C. ^{[30
]}

Fabbrocini, G. ^{[31
]}

机构：

[1] Magna Graecia Univ Catanzaro, Dept Hlth Sci, Catanzaro, Italy

[2] Univ Molise, Dept Med & Hlth Sci Vincenzo Tiberio, Campobasso, Italy

[3] Univ Campania, Dermatol Unit, Naples, Italy

[4] Univ Cattolica Sacro Cuore, Dermatol, Rome, Italy

[5] IRCCS, Fdn Policlin Univ A Gemelli, Rome, Italy

[6] Univ Turin, Dermatol Clin, Turin, Italy

[7] Univ Verona, Dept Med, Sect Dermatol, Verona, Italy

[8] Polytech Marche Univ, Dept Clin & Mol Sci, Dermatol Unit, Ancona, Italy

[9] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Milan, Italy

[10] UOC Dermatol, AO Cosenza, Cosenza, Italy

[11] ASST Spedali Civili Brescia, UO Dermatol, Brescia, Italy

[12] Univ Perugia, Dept Med, Dermatol Sect, Perugia, Italy

[13] Grande Osped Metropolitano Bianchi Melacrino More, Struttura Complessa Dermatol, Reggio Di Calabria, Italy

[14] Sapienza Univ Rome, Dermatol Unit, Rome, Italy

[15] Univ Bari, Dept Biomed Sci & Human Oncol, Bari, Italy

[16] S Andrea Hosp Vercelli, Dermatol Dept, Vercelli, Italy

[17] Univ Bologna, Dept Expt Diagnost & Specialty Med, Dermatol, Bologna, Italy

[18] Univ Pisa, Dept Dermatol, Pisa, Italy

[19] Tor Vergata Univ Rome, Dept System Med, Policlin Tor Vergata, Dermatol Unit, Rome, Italy

[20] Univ Udine, Inst Dermatol, Dept Med, Udine, Italy

[21] Univ Cagliari, Dept Med Sci & Publ Hlth, Unit Dermatol, Cagliari, Italy

[22] IRCCS Osped Ortoped Galeazzi, Dept Med Surg & Odontoiatr Sci, Milan, Italy

[23] San Gallicano Dermatol Inst IRCCS, Rome, Italy

[24] Univ Bari Aldo Moro, Sch & Chair Allergol & Clin Immunol, Dept Emergency & Organ Transplantat, Bari, Italy

[25] Univ Ferrara, Dept Med Sci, Sect Dermatol & Infect Dis, Ferrara, Italy

[26] Univ Messina, Dept Clin & Expt Med, Dermatol, Messina, Italy

[27] SS Annunziata Hosp, Dermatol Clin, Chieti, Italy

[28] Univ Aquila, Dept Biotechnol & Appl Clin Sci, Dermatol, Laquila, Italy

[29] Univ Padua, Dept Med DIMED, Unit Dermatol, Padua, Italy

[30] Sapienza Univ Rome, Fiorini Hosp, Dept MED Surg Sci & Biotechnol, Dermatol Unit Daniele Innocenzi, Terracina, Italy

[31] Univ Naples Federico II, Dept Clin Med & Surg, Sect Dermatol, Naples, Italy

来源：

JOURNAL OF THE EUROPEAN ACADEMY OF DERMATOLOGY AND VENEREOLOGY | 2021年 / 35卷 / 04期

关键词：

FEATURES; PLACEBO; ADULTS;

D O I：

10.1111/jdv.17094

中图分类号：

R75 [皮肤病学与性病学];

学科分类号：

100206 ;

摘要：

Background Treatment of moderate-to-severe atopic dermatitis (AD) in the elderly may be challenging, due to side-effects of traditional anti-inflammatory drugs and to comorbidities often found in this age group. Furthermore, efficacy and safety of innovative drugs such as dupilumab are not yet well known. Objectives A multicentre retrospective, observational, real-life study on the efficacy and safety of dupilumab was conducted in a group of patients aged >= 65 years and affected by severe AD. Their main clinical features were also examined. Methods Data of elderly patients with severe (EASI >= 24) AD treated with dupilumab at label dosage for 16 weeks were retrospectively collected. Treatment outcome was assessed by comparing objective (EASI) and subjective (P-NRS, S-NRS and DLQI) scores at baseline and after 16 weeks of treatment. Results Two hundred and seventy-six patients were enrolled in the study. They represented 11.37% of all patients with severe AD. Flexural eczema was the most frequent clinical phenotype, followed by prurigo nodularis. The coexistence of more than one phenotype was found in 63/276 (22.82%) subjects. Data on the 16-week treatment with dupilumab were available for 253 (91.67%) patients. Efficacy of dupilumab was demonstrated by a significant reduction of all the scores. No statistically significant difference regarding efficacy was found in elderly patients when compared to the group of our AD patients aged 18-64 years, treated with dupilumab over the same period. Furthermore, only 18 (6.52%) patients discontinued the drug due to inefficacy. Sixty-one (22.51%) patients reported adverse events, conjunctivitis and flushing being the most frequent. One (0.36%) patient only discontinued dupilumab due to an adverse event. Conclusions Therapy with dupilumab led to a significant improvement of AD over a 16-week treatment period, with a good safety profile. Therefore, dupilumab could be considered as an efficacious and safe treatment for AD also in the elderly.

引用

页码：958 / 964

页数：7

共 27 条

[1] Clinical phenotypes and endophenotypes of atopic dermatitis: Where are we, and where should we go? [J].

Bieber, Thomas ;

D'Erme, Angelo M. ;

Akdis, Cezmi A. ;

Traidl-Hoffmann, Claudia ;

Lauener, Roger ;

Schappi, Georg ;

Schmid-Grendelmeier, Peter .

JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY, 2017, 139 (04) :S58-S64

[2] Long-term management of moderate-to-severe atopic dermatitis with dupilumab and concomitant topical corticosteroids (LIBERTY AD CHRONOS): a 1-year, randomised, double-blinded, placebo-controlled, phase 3 trial [J].

Blauvelt, Andrew ;

de Bruin-Weller, Marjolein ;

Gooderham, Melinda ;

Cather, Jennifer C. ;

Weisman, Jamie ;

Pariser, David ;

Simpson, Eric L. ;

Papp, Kim A. ;

Hong, H. Chih-Ho ;

Rubel, Diana ;

Foley, Peter ;

Prens, Errol ;

Griffiths, Christopher E. M. ;

Etoh, Takafumi ;

Pinto, Pedro Herranz ;

Pujol, Ramon M. ;

Szepietowski, Jacek C. ;

Ettler, Karel ;

Kemeny, Lajos ;

Zhu, Xiaoping ;

Akinlade, Bolanle ;

Hultsch, Thomas ;

Mastey, Vera ;

Gadkari, Abhijit ;

Eckert, Laurent ;

Amin, Nikhil ;

Graham, Neil M. H. ;

Pirozzi, Gianluca ;

Stahl, Neil ;

Yancopoulos, George D. ;

Shumel, Brad .

LANCET, 2017, 389 (10086) :2287-2303

[3] Diagnosis and management of moderate to severe adult atopic dermatitis: a Consensus by the Italian Society of Dermatology and Venereology (SIDeMaST), the Italian Association of Hospital Dermatologists (ADOI), the Italian Society of Allergy, Asthma and Clinical Immunology (SIAAIC), and the Italian Society of Allergological, Environmental and Occupational Dermatology (SIDAPA) [J].

Calzavara Pinton, Piergiacomo ;

Cristaudo, Antonio ;

Foti, Caterina ;

Canonica, Giorgio W. ;

Balato, Nicola ;

Costanzo, Antonio ;

De Pita, Ornella ;

De Simone, Clara ;

Patruno, Cataldo ;

Pellacani, Giovanni ;

Peris, Ketty ;

Girolomoni, Giampiero .

GIORNALE ITALIANO DI DERMATOLOGIA E VENEREOLOGIA, 2018, 153 (02) :133-145

[4] Atopic dermatitis in the elderly Caucasian population: diagnostic clinical criteria and review of the literature [J].

Chello, Camilla ;

Carnicelli, Giorgia ;

Sernicola, Alvise ;

Gagliostro, Nazareno ;

Paolino, Giovanni ;

Di Fraia, Marco ;

Faina, Valentina ;

Muharremi, Rovena ;

Grieco, Teresa .

INTERNATIONAL JOURNAL OF DERMATOLOGY, 2020, 59 (06) :716-721

[5] Italian guidelines for therapy of atopic dermatitis-Adapted from consensus-based European guidelines for treatment of atopic eczema (atopic dermatitis) [J].

Damiani, Giovanni ;

Calzavara-Pinton, Piergiacomo ;

Stingeni, Luca ;

Hansel, Katharina ;

Cusano, Francesco ;

Pigatto, Paolo D. M. ;

Agostinelli, D. ;

Albertazzi, D. ;

Angelini, G. ;

Angerosa, F. ;

Arigliano, P. L. ;

Assalve, D. ;

Ayala, F. ;

Barbagallo, T. ;

Belloni-Fortina, A. ;

Berta, M. ;

Biale, C. ;

Bianchi, L. ;

Biasini, I. ;

Boccaletti, V. ;

Bonamonte, D. ;

Borghi, A. ;

Bragazzi, N. L. ;

Brambilla, L. ;

Bressan, M. ;

Brunasso, A. M. G. ;

Bruni, F. ;

Bruni, P. ;

Caccavalle, S. ;

Calogiuri, G. ;

Cannavo, S. P. ;

Carugno, A. ;

Cataldi, I. ;

Chiarelli, G. ;

Cirla, A. M. ;

Corazza, M. ;

Cossutta, M. ;

Cova, L. ;

Cristaudo, A. ;

Cusano, F. ;

Danese, P. ;

Dal Canton, M. ;

De Pita, O. ;

De Salvo, P. ;

Donini, M. ;

Fantini, F. ;

Ferrucci, S. M. ;

Flori, M. L. ;

Fontana, E. ;

Foti, C. .

DERMATOLOGIC THERAPY, 2019, 32 (06)

[6] Dupilumab with concomitant topical corticosteroid treatment in adults with atopic dermatitis with an inadequate response or intolerance to ciclosporin A or when this treatment is medically inadvisable: a placebo-controlled, randomized phase III clinical trial (LIBERTY AD CAFE) [J].

de Bruin-Weller, M. ;

Thaci, D. ;

Smith, C. H. ;

Reich, K. ;

Cork, M. J. ;

Radin, A. ;

Zhang, Q. ;

Akinlade, B. ;

Gadkari, A. ;

Eckert, L. ;

Hultsch, T. ;

Chen, Z. ;

Pirozzi, G. ;

Graham, N. M. H. ;

Shumel, B. .

BRITISH JOURNAL OF DERMATOLOGY, 2018, 178 (05) :1083-1101

[7] Effectiveness and safety of dupilumab for the treatment of atopic dermatitis in a real-life French multicenter adult cohort [J].

Faiz, Sarah ;

Giovannelli, Jonathan ;

Podevin, Celine ;

Jachiet, Marie ;

Bouaziz, Jean-David ;

Reguiai, Ziad ;

Nosbaum, Audrey ;

Lasek, Audrey ;

le Bouedec, Marie-Christine Ferrier ;

Aurelie Du Thah ;

Raison-Peyron, Nadia ;

Tetart, Florence ;

Duval-Modeste, Anne-Benedicte ;

Misery, Laurent ;

Aubin, Francois ;

Dompmartin, Anne ;

Morice, Cecile ;

Droitcourt, Catherine ;

Soria, Angele ;

Arnault, Jean-Philippe ;

Delaunay, Juliette ;

Mahe, Emmanuel ;

Richard, Marie-Aleth ;

Schoeffler, Amelie ;

Lacour, Jean-Philippe ;

Begon, Edouard ;

Walter-Lepage, Amelie ;

Dillies, Anne-Sophie ;

Rappelle-Duruy, Sandrine ;

Barete, Stephane ;

Bellon, Nathalia ;

Beneton, Nathalie ;

Valois, Aude ;

Barbarot, Sebastien ;

Senechal, Julien ;

Staumont-Salle, Delphine .

JOURNAL OF THE AMERICAN ACADEMY OF DERMATOLOGY, 2019, 81 (01) :143-151

[8] Real-life experience on effectiveness and safety of dupilumab in adult patients with moderate-to-severe atopic dermatitis [J].

Fargnoli, M. C. ;

Esposito, M. ;

Ferrucci, S. ;

Girolomoni, G. ;

Offidani, A. ;

Patrizi, A. ;

Peris, K. ;

Costanzo, A. ;

Malara, G. ;

Pellacani, G. ;

Romanelli, M. ;

Amerio, P. ;

Cristaudo, A. ;

Flori, M. L. ;

Motolese, A. ;

Betto, P. ;

Patruno, C. ;

Pigatto, P. ;

Sirna, R. ;

Stinco, G. ;

Zalaudek, I. ;

Bianchi, L. ;

Boccaletti, V. ;

Cannavo, S. P. ;

Cusano, F. ;

Lembo, S. ;

Mozzillo, R. ;

Gallo, R. ;

Potenza, C. ;

Rongioletti, F. ;

Tiberio, R. ;

Grieco, T. ;

Micali, G. ;

Persechino, S. ;

Pettinato, M. ;

Pucci, S. ;

Savi, E. ;

Stingeni, L. ;

Romano, A. ;

Argenziano, G. ;

Calabrese, Giulia ;

Campanati, Anna ;

Caruso, Cristiano ;

Chello, Camilla ;

De Pasquale, Tiziana ;

Di Costanzo, Luisa ;

Dini, Valentina ;

De Pasquale, Rocco ;

Del Giglio, Micol ;

Fracassi, Giovanna .

JOURNAL OF DERMATOLOGICAL TREATMENT, 2021, 32 (05) :507-513

[9]

Igelman Sean J, 2020, JAAD Case Rep, V6, P139, DOI 10.1016/j.jdcr.2019.12.002

[10]

Kanwar Amrinder Jit, 2013, Indian Dermatol Online J, V4, P167, DOI 10.4103/2229-5178.115508

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