Assessing the risk of dupilumab use for atopic dermatitis during the COVID-19 pandemic

Kearns, Donovan G; Uppal, S. K.; Chat, Vipawee S; Wu, Jashin J.

doi:10.1016/j.jaad.2020.06.015

Cited by 18 publications

(21 citation statements)

References 5 publications

(4 reference statements)

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“…[9][10][11][12] In dupilumab clinical trials, rates of general infections, upper respiratory tract infections, and nasopharyngitis resulted similar to placebo, and, in particular, viral infections, were not reported as meaningful adverse event. 7,13 In terms of effectiveness, dupilumab therapy obtained a satisfactory control of the disease and consistently with the other systemic compounds, treatment interruption did not cause a rapid and relevant worsening of the disease, as highlighted by the decrease of both patient-assessed severity scores and EASI score in patients discontinuing therapy. This finding is in line with a recent study reporting maintenance of EASI-75 response in 30.4% of high-responding patients treated with dupilumab, after rerandomization to placebo.…”

Section: Discussionmentioning

confidence: 79%

“…The effect of immunomodulant/immunosuppressive compounds on the clinical course of COVID-19 is currently unclear and there is concern of an increased risk of infection in AD patients treated with systemic compounds, though the continuation of therapy during pandemic was recommended by national and international scientific societies. [2][3][4][5][6][7] Nevertheless, immunomodulant/immunosuppressive agents, such as methotrexate, mycophenolate, azathioprine, and cyclosporine were suggested to be tapered to the lowest effective dose, likely avoiding disease flare, and to consider drug discontinuation in patients when viral symptoms are present. 2,5 Similarly, caution was recommended in prescribing systemic corticosteroids given their broad immunosuppressive effects.…”

Section: Introductionmentioning

confidence: 99%

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Management of patients with atopic dermatitis undergoing systemic therapy during COVID-19 pandemic in Italy: data from the DA-COVID-19 registry Running title: AD management during COVID-19 pandemic

Chiricozzi¹,

Talamonti²,

Simone³

et al. 2021

Preprint

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Background: Few and small studies have described the management of immunomodulant/immunosuppressive therapies or phototherapy in atopic dermatitis (AD) patients during coronavirus disease 2019 (COVID-19) pandemic. Methods: A national registry, named DA-COVID-19 and involving 35 Italian dermatology units, was established in order to evaluate the impact of COVID-19 pandemic on the management of adult AD patients treated with systemic immunomodulant/immunosuppressive medications or phototherapy. Demographic and clinical data were obtained at different timepoints by teledermatology during COVID-19 pandemic, when regular visits were not allowed due to sanitary restrictions. Disease severity was assessed by both physician- and patient-reported assessment scores evaluating itch intensity, sleep disturbances, and AD severity. Results: A total of 1831 patients were included, with 1580/1831 (86.3%) continuing therapy during pandemic. Most patients were treated with dupilumab (86.1%, 1576/1831) that was interrupted in only 9.9% (156/1576) of cases, while systemic immunosuppressive compounds were more frequently withdrawn. Treatment interruption was due to decision of the patient, general practitioner or dermatologist in 39.9% (114/286), 5.6% (16/286), and 30.1% (86/286) of cases, respectively. Fear of increased susceptibility to SARS-CoV-2 infection (24.8%, 71/286) was one of the main causes of interruption. Sixteen patients (0.9%) resulted positive to SARS-CoV-2 infection, 3 of them (0.2%) were hospitalized but no cases of COVID-related death occurred. Conclusions: Most AD patients continued systemic treatments during COVID pandemicand lockdown period, without high impact on disease control, particularly dupilumab-treatedpatients.

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Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Management of patients with atopic dermatitis undergoing systemic therapy during COVID-19 pandemic in Italy: data from the DA-COVID-19 registry Running title: AD management during COVID-19 pandemic

Chiricozzi¹,

Talamonti²,

Simone³

et al. 2021

Preprint

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“… 18 Patients on treatment with biologics, in particular ruplizumab for severe atopic dermatitis, interleukin (IL)-17-, 12- and 23-inhibitors for moderate to severe psoriasis and psoriatic arthritis, IL-6 inhibitors for rheumatoid arthritis and related disorders, TNF-alfa inhibitors for moderate to severe hidradenitis suppurativa / acne inverse should be continued during COVID-19 pandemic, because the relapse of disease after discontinuation of such drugs poses a higher risk to patients. 19 , 20 , 21 , 22 , 23 …”

Section: Methodsmentioning

confidence: 99%

How dermatology has changed in the COVID-19 pandemic

Karadağ

Kayıran

Wollina

2021

Clinics in Dermatology

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The mergence of the COVID-19 pandemic has led to a change in the whole world order. The key actors and the occupational group most at risk during this period have been the healthcare professionals. In this pandemic, we, as dermatologists, also have many responsibilities regarding patients, ourselves, and society. Dermatologists have to protect themselves, their families and their patients while working in pandemic services and outpatient clinics, as well as in their practices. One of their roles is to inform the public about protective measures for cutaneous side effects associated with the intensive use of disinfectant and long-term use of masks. During the pandemic, in hospitals, only emergency patients had been admitted for treatment in all units, and elective operations and procedures were delayed. In this context, it is very important to determine what procedures will be carried out during this period in the follow-up and treatment of chronic dermatologic diseases as well as what interventional and cosmetic procedures may performed. Guidelines issued by the various medical societies have made valuable contributions. The benefits and associated issues of teledermatology have associated pros and cons. Finally, one of the issues to ponder in the long view seems to be "How should we pursue online education?".

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“…A clinical trial meta-analysis investigated infection rates with dupilumab in pivotal phase 3 trials for AD. 22 This study examined rates of overall infection, URTI, and nasopharyngitis. Across these three infection categories, the rate of infection was not increased in dupilumab-treated patients compared with placebo.…”

Section: Introductionmentioning

confidence: 99%

“…Across these three infection categories, the rate of infection was not increased in dupilumab-treated patients compared with placebo. 22 …”

Section: Introductionmentioning

confidence: 99%

The Use of Biologics During the COVID-19 Pandemic

Jones

Kohn

Pourali

et al. 2021

Dermatologic Clinics

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Synopsis: During the COVID-19 pandemic, there has been considerable discussion regarding the use of biologics in patients with inflammatory skin conditions, such as psoriasis, hidradenitis suppurativa, and atopic dermatitis. This article discusses clinical trial data, real world evidence, and guidelines and recommendations for biologics that inhibit TNF, IL-12/23, IL-17, IL-23, and IL-4/13 during the COVID-19 pandemic. Across these inflammatory skin conditions, existing data generally suggest that biologics do not appear to increase the risk of COVID-19 infection nor worsen COVID-19 outcomes. The impact of biologics on COVID-19 is an area of active exploration.

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Assessing the risk of dupilumab use for atopic dermatitis during the COVID-19 pandemic

Cited by 18 publications

References 5 publications

Management of patients with atopic dermatitis undergoing systemic therapy during COVID-19 pandemic in Italy: data from the DA-COVID-19 registry Running title: AD management during COVID-19 pandemic

Management of patients with atopic dermatitis undergoing systemic therapy during COVID-19 pandemic in Italy: data from the DA-COVID-19 registry Running title: AD management during COVID-19 pandemic

How dermatology has changed in the COVID-19 pandemic

The Use of Biologics During the COVID-19 Pandemic

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