Effectiveness and safety of dupilumab for the treatment of atopic dermatitis in a real-life French multicenter adult cohort

被引:165
作者
Faiz, Sarah [1 ]
Giovannelli, Jonathan [1 ,2 ]
Podevin, Celine [2 ]
Jachiet, Marie [3 ,4 ]
Bouaziz, Jean-David [3 ,4 ]
Reguiai, Ziad [5 ]
Nosbaum, Audrey [6 ,7 ]
Lasek, Audrey [8 ]
le Bouedec, Marie-Christine Ferrier [9 ]
Aurelie Du Thah [10 ]
Raison-Peyron, Nadia [10 ]
Tetart, Florence [11 ]
Duval-Modeste, Anne-Benedicte [11 ]
Misery, Laurent [12 ]
Aubin, Francois [13 ]
Dompmartin, Anne [14 ]
Morice, Cecile [14 ]
Droitcourt, Catherine [15 ]
Soria, Angele [16 ,17 ]
Arnault, Jean-Philippe [18 ]
Delaunay, Juliette [19 ]
Mahe, Emmanuel [20 ]
Richard, Marie-Aleth [21 ]
Schoeffler, Amelie [22 ]
Lacour, Jean-Philippe [23 ]
Begon, Edouard [24 ]
Walter-Lepage, Amelie [25 ]
Dillies, Anne-Sophie [26 ]
Rappelle-Duruy, Sandrine [27 ]
Barete, Stephane [28 ]
Bellon, Nathalia [29 ]
Beneton, Nathalie [30 ]
Valois, Aude [31 ]
Barbarot, Sebastien [32 ]
Senechal, Julien [33 ,34 ]
Staumont-Salle, Delphine [1 ,2 ]
机构
[1] CHU Lille, Serv Dermatol, F-59000 Lille, France
[2] Univ Lille, INSERM U995, Lille Inflammat Res Int Ctr, F-59000 Lille, France
[3] Dermatol Dept, Paris, France
[4] Univ Paris Diderot Paris VII, St Louis Hosp, AP HP, Sorbonne Paris Cite, Paris, France
[5] Polyclin Courlancy, Serv Dermatol, Reims, France
[6] Univ Lyon, Lyon Sud Univ Hosp, Allergy & Clin Immunol Dept, Lyon, France
[7] Univ Claude Bernard Lyon 1, INSERM U1111, Int Ctr Infectiol Rese, Ecole Normale Super Lyon, Lyon, France
[8] Hosp St Vincent Paul, Grp Hop Inst Catholique Lille, Serv Dermatol, Lille, France
[9] Univ Clermont Ferrand, Dermatol Dept, Clermont Ferrand, France
[10] Univ Montpellier, Serv Dermatol, CHU Montpellier, PCCI,INSERM, Montpellier, France
[11] Rouen Univ Hosp, Dept Dermatol, Inserm U519, Rouen, France
[12] Univ Hosp Brest, Dept Dermatol, Brest, France
[13] Univ Franche Comte, Serv Dermatol, Ctr Hosp Reg Univ Besancon, Besancon, France
[14] Caen Univ Hosp Ctr, Dept Dermatol, Caen, France
[15] Univ Rennes, Ctr Hosp Univ Pontchaillou, Serv Dermatol, Rennes, France
[16] Hop Tenon, AP HP, Paris HUEP, Serv Dermatol & Allergol, Paris, France
[17] Sorbonne Univ Paris, Cimi Paris, INSERM U1135, Paris, France
[18] Amiens Univ Hosp, Dept Dermatol, Amiens, France
[19] CHU Angers, Serv Dermatol, Angers, France
[20] Hop Victor Dupouy Argenteuil, Dept Dermatol, Argenteuil, France
[21] Aix Marseille Univ, Timone Hosp, AP HM, EA 3279,CEReSS Hlth Serv Res & Qual Life Ctr,Derm, F-13385 Marseille, France
[22] Ctr Hosp Reg Metz Thionville, Serv Dermatol, Hop Bel Air, Metz, France
[23] CHU Nice, Serv Dermatol, Hop Archet 2, Nice, France
[24] Ctr Hosp Rene Dubos, Serv Dermatol, Pontoise, France
[25] CHU La Miletrie, Serv Dermatol, Poitiers, France
[26] Ctr Hosp St Quentin, Serv Dermatol, St Quentin en Yvelines, France
[27] Hop Joseph Imbert, Serv Dermatol, Ctr Hosp Arles, St Quentin en Yvelines, France
[28] Sorbonne Univ, Hop La Pitie Salpetriere, AP HP, Unite Fonct Dermatol, Paris, France
[29] Hop Necker Enfants Malad, AP HP, Serv Dermatol, Paris, France
[30] Ctr Hosp Le Mans, Serv Dermatol, Le Mans, France
[31] Hop Instruct Armees St Anne, Serv Dermatol, Toulon, France
[32] CHU Nantes, Serv Dermatol, Nantes, France
[33] CHU Bordeaux, Hop St Andre, Serv Dermatol, Ctr Reference Malad Rares Peau, Bordeaux, France
[34] Univ Bordeaux, INSERM Biotherapie Malad Genet Inflammatoires & C, Immunodermatol ATIP AVENIR, Bordeaux, France
关键词
adults; atopic dermatitis; biotherapy; conjunctivitis; dupilumab; eosinophilia; PERSISTENT ASTHMA; PLACEBO;
D O I
10.1016/j.jaad.2019.02.053
中图分类号
R75 [皮肤病学与性病学];
学科分类号
100206 ;
摘要
Background: Dupilumab is the first biologic available to treat atopic dermatitis (AD). Its effectiveness and safety were demonstrated in clinical trials. Objective: We sought to assess the effectiveness and safety of dupilumab in adults with AD in a real-life French multicenter retrospective cohort. Methods: We included patients treated during March 2017-April 2018. Efficacy outcomes, including Scoring Atopic Dermatitis (SCORAD) and Eczema Area and Severity Index (EASI) scores, were collected at baseline and 3 months when available. Adverse events (AEs) were recorded at follow-up. Results: We included 241 patients. The median 6 interquartile range (IQR) follow-up time was 3.8 +/- 3.7 months. A >= 75% improvement in SCORAD was achieved in 27 of 163 (16.6%) patients, and a >= 75% improvement in EASI was achieved in 40 of 82 (48.8%) patients. The median SCORAD and EASI scores at 3 months were significantly lower than those at baseline (SCORAD +/- IQR, 25 +/- 21 vs 56 +/- 27.4, P < 10(-9) and EASI +/- IQR, 4.1 +/- 6.8 vs 17.9 +/- 15.4, P < 10(-9), respectively). Conjunctivitis was reported in 84 of 241 (38.2%) patients. The proportion with eosinophilia (<500 cells/mm(3)) during follow-up (57%) was higher than that at baseline (33.7%) (n = 172, P < 10(-6)). Dupilumab was stopped in 42 cases; 27 patients stopped because of AEs. Limitations: No control group, missing data. Conclusion: This real-life study demonstrated a similar dupilumab effectiveness as that seen in clinical trials, but it also revealed a higher frequency of conjunctivitis and eosinophilia.
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收藏
页码:143 / 151
页数:9
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