Use of Dupilumab in 543 Adult Patients With Moderate-to-Severe Atopic Dermatitis: A Multicenter, Retrospective Study

被引：47

作者：

Nettis, E. ^{[1
]}

Ferrucci, S. M. ^{[2
,3
]}

Ortoncelli, M. ^{[4
]}

Pellacani, G. ^{[5
]}

Foti, C. ^{[6
]}

Di Leo, E. ^{[7
]}

Patruno, C. ^{[8
]}

Rongioletti, F. ^{[9
]}

Argenziano, G. ^{[10
]}

Macchia, L. ^{[1
]}

Tavecchio, S. ^{[2
,3
]}

Napolitano, M. ^{[11
]}

Ribero, S. ^{[4
]}

Bonzano, L. ^{[12
]}

Romita, P. ^{[6
]}

Di Bona, D. ^{[1
]}

Nistico, S. P. ^{[8
]}

Piras, V ^{[9
]}

Calabrese, G. ^{[10
]}

Detoraki, C. ^{[13
]}

Carbonara, M. ^{[14
]}

Fabbrocini, G. ^{[15
]}

机构：

[1] Univ Bari Aldo Moro, Sch & Chair Allergol & Clini Cal Immunol, Dept Emergency & Organ Transplantat, Bari, Italy

[2] Fdn IRCCS Ca Granda Osped Maggiore Policlin, UOC Dermatol, Milan, Italy

[3] Univ Milan, Dipartimento Fisiopatol Med Chirurg & Trapianti, Milan, Italy

[4] Univ Turin, Med Sci Dept, Dermatol Clin, Turin, Italy

[5] Univ Modena & Reggio Emilia, Dermatol, Modena, Italy

[6] Univ Bari, Dept Biomed Sci & Human Oncol, Dermatol Clin, Bari, Italy

[7] F Miulli Hosp, Sect Allergy & Clin Immunol, Unit Internal Med, Acquaviva Delle Fonti, BA, Italy

[8] Magna Graecia Univ Catanzaro, Dept Hlth Sci, Unit Dermatol, Catanzaro, Italy

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

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

[11] Univ Molise, Dept Hlth Sci Vincenzo Tiberio, Campobasso, Italy

[12] AUSL Modena, Allergol Serv, Modena, Italy

[13] Azienda Osped Univ Federico II, Dept Internal Med & Clin Pathol, Naples, Italy

[14] Natl Inst Stat ISTAT, Bari, Italy

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

来源：

JOURNAL OF INVESTIGATIONAL ALLERGOLOGY AND CLINICAL IMMUNOLOGY | 2022年 / 32卷 / 02期

关键词：

Atopic dermatitis; Dupilumab; Multicenter real-life study; ECZEMA; EASI;

D O I：

10.18176/jiaci.0641

中图分类号：

R392 [医学免疫学];

学科分类号：

100102 ;

摘要：

Background: Dupilumab has proven to be an effective treatment for patients with moderate-to-severe atopic dermatitis (AD) in clinical trials. However, real-world experience with dupilumab in a broader population is limited. Methods: The study population comprised adult patients with moderate-to-severe AD, defined as an Eczema Area Severity Index (EASI) score of 24 or higher, treated with dupilumab at 10 Italian teaching hospitals. We analyzed physician-reported outcome measures (EASI), patient-reported outcome measures (pruritus and sleep score, Dermatology Life Quality Index [DLQI]), and serological markers (IgE and eosinophil count) after 16 weeks. Results: We enrolled 543 patients with moderate-to-severe AD. Two patients (0.4%) discontinued treatment. The median (IQR) change from baseline to 16 weeks of treatment in the EASI score was -87.5 (22.0) (P<. 001). The EASI-50, EASI-75, and EASI-90 response rates were 98.1%, 81.5%, and 50.8% after 16 weeks. At 16 weeks, 93.0% of the patients had achieved a 4-point or higher improvement in DLQI from baseline. During treatment with dupilumab, 12.2% of the patients developed conjunctivitis, and total IgE decreased significantly (P<. 001). Interestingly, in the multivariate logistic regression model, the risk of developing dupilumab-related conjunctivitis was associated with early onset of AD (OR, 2.25; 95%CI, 1.07-4.70; P=. 03) and presence of eosinophilia (OR, 1.91; 95%CI, 1.05-3.39; P=. 03). Conclusion: This is the broadest real-life study in AD patients treated with dupilumab to date. We observed more significant improvements induced by dupilumab in adult patients with moderate-to-severe AD than those reported in clinical trials.

引用

页码：124 / 132

页数：9

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