Efficacy of dupilumab in atopic comorbidities associated with moderate‐to‐severe adult atopic dermatitis

Abstract

Background: Dupilumab is an anti-IL-4Rα antibody used in the treatment of patients with moderate-to-severe atopic dermatitis (msAD). This study explored the potential benefit of dupilumab in perennial allergic rhinoconjunctivitis (PAR) and perennial allergic asthma (PAA) caused by indoor allergens in adults with msAD. Methods: This multicentric, prospective, observational, real-life study included adult patients with msAD who had been treated with dupilumab in 16 Italian care centres. Efficacy outcomes regarding AD, PAR and PAA were collected at baseline and 16 weeks. Safety was also assessed. Results: We enrolled 123 patients with msAD. Between baseline and 16 weeks of treatment, the following measurements decreased statistically significantly: Eczema Area and Severity Index, SCOring AD, Patient-Oriented Eczema Measure, pruritus score, sleep score, Dermatology Life Quality Index and IgE. Dupilumab treatment in patients with comorbid PAR (n = 41) was associated with significant improvements in PAR disease control (measured using a Rhinitis Control Scoring System) and in PAR Quality of life (QoL) (measured using the Rhinoconjunctivitis QoL Questionnaire scores). In 32 patients with comorbid PAA, dupilumab significantly improved PAA control (measured using the Asthma Control Test and five-item Asthma Control Questionnaire scores) and disease-related QoL (measured using the Asthma QoL Questionnaire scores). Thirty-five patients (28.5%) developed conjunctivitis during the study period. Conclusion: These results support the benefits of dupilumab for adult patients with PAR and/or PAA associated with msAD.

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

“…Dupilumab has been demonstrated to be an effective treatment for patients with moderateto-severe AD in clinical trials [9][10][11] and in real-life studies [2,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]. To date, there have been some reports on real-world experience with dupilumab, including six multicenter studies [14,19,[22][23][24]26].…”

“…As regards the safety of dupilumab, new onset conjunctivitis was observed in 66 patients (12.2%). The reported incidence in clinical trials [9][10][11]and in real-life studies [2,[19][20][21][22][23][24][25][26][27][28][29][30][31][32][33]39]ranges from 5% to 28%, and from 6% to 62% of dupilumab-treated patients, respectively. During the clinical development of dupilumab in AD [40], the incidence of conjunctivitis was around 10% and infrequent in patients with asthma or nasal polyposis, suggesting that some characteristics of patients with AD may contribute to cause this, as eye involvement can be a comorbidity in AD [41].…”

“…Atopic dermatitis (AD) is a common inflammatory skin disease, with a prevalence of 2-8% in the adult population and up to 20% in infants in most countries around the world [1]. Affected patients suffer from persistent or relapsing skin lesions associated with a spectrum of atopic comorbidities [2]. AD negatively impacts the quality of life (QoL) of patients in health-related aspects such as physical, psychosocial, and mental functioning [3].…”

“…J Investig Allergol Clin Immunol 2022; Vol. 32(2) © 2020 Esmon Publicidad doi: 10.18176/jiaci.0641a Significantp Values are shown in bold (P-values are statistically significant at a threshold of 5%).b Lichenified/exudative flexural dermatitis alone or associated with head-and-neck eczema and/or hand eczema.…”

MRGPRX2 signals its importance in cutaneous mast cell biology: Does MRGPRX2 connect mast cells and atopic dermatitis?

“…[53] In support of this, patients with extrinsic AD have more pronounced barrier defects than those with intrinsic AD. [54] There is also limited improvement of AD with IgEdirected strategies (Omalizumab), especially in patients with pure AD and the same applies to specific immunotherapy (reviewed in [55][56][57][58] ).…”