Dupilumab with Topical Corticosteroids Provides Rapid and Sustained Improvement in Adults with Moderate-to-Severe Atopic Dermatitis Across Anatomic Regions Over 52 Weeks

Abstract

Introduction In a 52-week, phase 3 clinical trial (LIBERTY AD CHRONOS) in adult patients with moderate-to-severe atopic dermatitis (AD), dupilumab in combination with topical corticosteroids (TCS) resulted in a significant improvement in overall Eczema Area and Severity Index (EASI) compared with placebo plus TCS. In a post hoc analysis, dupilumab significantly improved the overall extent and severity of AD across four anatomic regions (head and neck, trunk, upper extremities, lower extremities) over 16 weeks. However, as AD severity and presentation may vary by body region, this analysis sought to determine whether there are regional variations in dupilumab efficacy. Methods Using data from the LIBERTY AD CHRONOS study, we performed a post hoc analysis of the mean percentage change in individual EASI signs (erythema, infiltration/papulation, excoriation, lichenification) from baseline through week 52 across four anatomic regions (head and neck, trunk, upper extremities, lower extremities). Results Dupilumab plus TCS, compared with placebo plus TCS, significantly improved the severity of all individual AD signs to a similar extent across the four anatomic regions. Significant improvements in each sign were seen early, within the first 2–4 weeks of treatment, and were sustained through week 52 across all regions. Conclusions In adult patients with moderate-to-severe AD, treatment with dupilumab resulted in rapid and sustained improvement in the signs of AD across all anatomic regions. Trial registration LIBERTY AD CHRONOS (NCT02260986).

Dupilumab Demonstrates Rapid Onset of Action in Improving Signs, Symptoms and Quality of Life in Adults with Atopic Dermatitis

“…The findings of PROLEAD were also comparable with real-world data from the BIOREP registry [29]. A similar improvement in mean percentage change in EASI scores was observed across the four body regions in PROLEAD as was reported in the posthoc analysis of LIBERTY AD CHRONOS, a phase 3, randomised, double-blind, placebo-controlled 1-year trial of dupilumab in combination with TCS in patients with moderate-to-severe AD [12]. Prior systemic AD treatment did not impact treatment response to dupilumab in PROLEAD and this was also evident in the CHRONOS post-hoc analysis [30].…”

“…In a pooled analysis of these two 16-week studies with identical design, dupilumab significantly improved signs, symptoms and QoL compared with placebo and showed a favourable safety profile [ 11 ]. In a phase 3 randomised, controlled clinical study (LIBERTY AD CHRONOS), combination therapy with dupilumab and topical corticosteroids (TCS) showed improvements in signs of moderate-to-severe AD [ 12 ].…”

A Review of Dupilumab in the Treatment of Atopic Dermatitis in Infants and Children

“…In addition, similar improvements of the head and neck region as elsewhere have been observed in children and adolescents. 42,[60][61][62] However, in clinical practice, some patients have responded that dupilumab is not as effective in treating the face and neck as the trunk and extremities. In such cases, combinations may increase efficacy, but the safety of combinations on the face in infants and children is also a matter of concern.…”