Atopic dermatitis in adolescents: Effectiveness and safety of dupilumab in a 16‐week real‐life experience during the COVID ‐19 pandemic in Italy

Abstract

Dupilumab showed significant improvement of adolescent atopic dermatitis (AD) signs and symptoms in clinical trials, with a good safety profile. Herein we report the real‐word effectiveness and safety of dupilumab in adolescents with moderate to severe AD from January to October 2020, during the COVID‐19 pandemic in Italy. All patients had a diagnosis of AD for a mean [SD] 12.8 [3.1] years. Baseline demographics, AD characteristics (EASI, cDLQI, NRS itch score, NRS sleep loss score) at baseline and week 16, and safety data were collected. Nineteen patients (52.6% men; mean [SD] age, 15.6 [1.4] years [range, 13–17 years]) were included in the analysis. All patients reached EASI‐50 and 78.9% EASI‐75, especially in those with EASI≥30 and BMI < 25 at baseline, with marked reduction for cDLQI (77.4%), NRS itch score (5.9 point), and NRS sleep loss score (87.5%). One patient contracted asymptomatic SARS‐CoV‐2 infection and 1 developed mild conjuntivitis, without stopping dupilumab. In this real‐word experience the effectiveness of dupilumab was excellent and resulted higher than that observed in clinical trials, with a good safety profile during COVID‐19 pandemic.

Impact of Anti-Type 2 Inflammation Biologic Therapy on COVID-19 Clinical Course and Outcome

“…No greater susceptibility to SARS-CoV-2 infection was noticed: indeed, only one case was detected, whose clinical course was without any symptoms. 42 Later (online publication: July 2021), this same Italian group described 9 adolescents undergoing 32-week dupilumab treatment during the pandemic. Again, only one case of COVID-19 at week-10 was mentioned, and this is supposed to be the same reported in the previous article.…”

Traitements systémiques et risque infectieux dans le contexte de pandémie COVID-19

“…Plusieurs études ont analysé les cas de COVID-19 chez les patients traités par dupilumab (anti-IL-4Rα) sans trouver de surrisque de forme sévère [ 33 , 34 ]. Certaines équipes proposent d’ailleurs de remplacer les traitements IMD et IMS des patients atteints de dermatite atopique par du dupilumab d’emblée [ 35 ].…”

Patients Withdrawing Dupilumab Monotherapy for COVID-19–Related Reasons Showed Similar Disease Course Compared With Patients Continuing Dupilumab Therapy

“…Numerous vaping-associated dermatological conditions have been reported, such as thermal injuries, oral lesions, and contact dermatitis. 1 We report a case of allergic contact dermatitis (ACD) related to flavorings contained in e-cigarette refill oils.…”

“…During COVID-19 pandemic, a few studies described the therapeutic management of AD. [1][2][3] In Italy, the DA-COVID-19 national registry was created to collect clinical data about the management of moderate-severe AD patients during the lockdown period (starting from February to June 2020). Pandemicrelated sanitary restrictions limited the access to hospitals and determined the implementation of regular visits with telemedicine, resulting in a predominant patient-oriented assessment of disease severity.…”

“…During COVID-19 pandemic, a few studies described the therapeutic management of AD 1–3 . In Italy, the DA-COVID-19 national registry was created to collect clinical data about the management of moderate-severe AD patients during the lockdown period (starting from February to June 2020).…”