Impact of nonsegmental vitiligo on patients’ health-related quality of life in the United States

Abstract

Patients were compared according to the following criteria at the first visit after dose spacing (V1): firstly, continued clinical improvement as documented by the treating clinician, and secondly, resolution of AEs. The t-test or Wilcoxon test was used for the statistical analysis of continuous variables and the Fisher or v 2 -test for categorical variables.Eighty-eight (8Á7%) of the 1017 patients receiving dupilumab in 11 centres across France were enrolled in the study. Dose spacing was introduced for AEs, response, and both AEs and response in 18 (20%), 55 (63%) and 15 (17%) patients, respectively. The patients' baseline characteristics are presented in Table 1. AEs comprised ocular AEs (58%), hyper-eosinophilia (17%), head and neck dermatitis (13%), headaches (7%), pain at the injection site (5%), fatigue (3%), diarrhoea (1%) and induced psoriasis (1%). Dose spacing comprised one 300-mg injection every 3 weeks or every 4 weeks for 64 (73%) and 24 (27%) patients, respectively. Maintained clinical response was noted in 56 patients (64%) at V1.A second follow-up was performed for 50 patients (57%) (V2). Maintained clinical response was documented for 37 patients (74%) at V2. Detailed clinical outcomes at V1 and V2 are presented in Table 1. Among those patients who returned to the initial dose at V1 due to loss of response (22), 10 were followed up at V2. Eight of these re-achieved response (80%). Positive factors associated with maintained clinical response were spacing for good response [47 (84%) in the maintained response group vs. 19 (61%) in the loss-of-response group, P = 0Á034], age of the patient [median age 45Á7 years (interquartile range 32Á3-55Á3) for maintained response vs. 33Á5 years (interquartile range 25Á1-43Á1) for loss of response, P = 0Á006] and the median dose of concomitant topical corticosteroids applied in the last month (10 g for maintained response vs. 15 g for loss of response, P = 0Á016). No significant related factor was documented for AE resolution.This study shows that a longer dupilumab dosing interval in patients achieving clinically relevant improvement is linked to maintained efficacy in two-thirds of patients. This strategy seems to be more effective in older patients, patients with lower topical corticosteroid usage and those in whom this strategy was implemented when the patient was in clinical good response to reduce the treatment burden, rather than for an AE. In patients presenting AEs, this strategy seems to be effective in reducing their intensity.In the LIBERTY AD SOLO-CONTINUE study, high-responding patients taking dupilumab every 4 weeks maintained ≥ 75% improvement in Eczema Area and Severity Index in 58Á3% of cases. 1 Our results seem to be more promising. However, the majority of patients were taking dupilumab every 3 weeks in this study (73%).To conclude, a longer dupilumab dosing interval may be introduced for patients achieving a good clinical response and who are motivated to do so. This may prove to be an effective strategy for reducing treatment burden and t...